Provider Demographics
NPI:1386673499
Name:HAROLD B. BETTON, M.D. P.A.
Entity Type:Organization
Organization Name:HAROLD B. BETTON, M.D. P.A.
Other - Org Name:BETTON CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HAROLD
Authorized Official - Middle Name:BYRD
Authorized Official - Last Name:BETTON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:501-376-1160
Mailing Address - Street 1:1505 W 11TH ST
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72202-4619
Mailing Address - Country:US
Mailing Address - Phone:501-376-1160
Mailing Address - Fax:501-376-3977
Practice Address - Street 1:1505 W 11TH ST
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72202-4619
Practice Address - Country:US
Practice Address - Phone:501-376-1160
Practice Address - Fax:501-376-3977
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-01
Last Update Date:2011-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARMC-0637207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR104803002Medicaid
AR57334Medicare ID - Type Unspecified