Provider Demographics
NPI:1235778515
Name:ARKANSAS VASCULAR SURGERY, PLLC
Entity Type:Organization
Organization Name:ARKANSAS VASCULAR SURGERY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/VASCULAR SURGEON
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:RYAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:501-251-7787
Mailing Address - Street 1:11300 N RODNEY PARHAM RD STE 210
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72212-4149
Mailing Address - Country:US
Mailing Address - Phone:501-313-1001
Mailing Address - Fax:501-663-4145
Practice Address - Street 1:11300 N RODNEY PARHAM RD STE 210
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72212-4149
Practice Address - Country:US
Practice Address - Phone:501-251-7787
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-03
Last Update Date:2020-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Single Specialty