Provider Demographics
NPI:1235376104
Name:GASTROENTEROLOGY & SURGERY CENTER OF ARKANSAS, II, LLC.
Entity Type:Organization
Organization Name:GASTROENTEROLOGY & SURGERY CENTER OF ARKANSAS, II, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:W
Authorized Official - Last Name:HOLST
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-345-6900
Mailing Address - Street 1:PO BOX 55660
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72215-5660
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:401 COMMERCE ST
Practice Address - Street 2:SUITE 600
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37219-2446
Practice Address - Country:US
Practice Address - Phone:615-345-6900
Practice Address - Fax:615-691-7214
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-14
Last Update Date:2016-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical