Provider Demographics
NPI:1326135849
Name:ARKANSAS OB GYN ASSOCIATES PLLC
Entity Type:Organization
Organization Name:ARKANSAS OB GYN ASSOCIATES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:RANDALL
Authorized Official - Middle Name:BRIAN
Authorized Official - Last Name:GUARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:501-801-7900
Mailing Address - Street 1:9501 LILE DR
Mailing Address - Street 2:SUITE 777
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-6225
Mailing Address - Country:US
Mailing Address - Phone:501-801-7900
Mailing Address - Fax:501-801-7905
Practice Address - Street 1:9501 LILE DR
Practice Address - Street 2:SUITE 777
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-6225
Practice Address - Country:US
Practice Address - Phone:501-801-7900
Practice Address - Fax:501-801-7905
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARC8487207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty