Provider Demographics
NPI:1316188774
Name:ARKANSAS HEALTH GROUP
Entity Type:Organization
Organization Name:ARKANSAS HEALTH GROUP
Other - Org Name:BAPTIST HEALTH WOUND CARE AND HYPERBARIC CENTER NORTH LITTLE ROCK
Other - Org Type:Doing Business As
Authorized Official - Title/Position:RPA
Authorized Official - Prefix:MRS
Authorized Official - First Name:KIM
Authorized Official - Middle Name:
Authorized Official - Last Name:TITSWORTH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:501-812-7587
Mailing Address - Street 1:11001 EXECUTIVE CENTER DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72211-4316
Mailing Address - Country:US
Mailing Address - Phone:501-812-7800
Mailing Address - Fax:501-812-7851
Practice Address - Street 1:3333 SPRINGHILL DR
Practice Address - Street 2:
Practice Address - City:NORTH LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72117-2922
Practice Address - Country:US
Practice Address - Phone:501-202-3638
Practice Address - Fax:501-202-3639
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-16
Last Update Date:2009-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207PE0005XAllopathic & Osteopathic PhysiciansEmergency MedicineUndersea and Hyperbaric MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR176934002Medicaid
AR5G234Medicare PIN