Provider Demographics
NPI:1497854640
Name:ARKANSAS CENTER FOR SLEEP MEDICINE
Entity Type:Organization
Organization Name:ARKANSAS CENTER FOR SLEEP MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:E
Authorized Official - Last Name:WYLIE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:501-303-0223
Mailing Address - Street 1:11219 FINANCIAL CENTRE PKWY STE 315
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72211-3895
Mailing Address - Country:US
Mailing Address - Phone:501-661-9299
Mailing Address - Fax:501-661-1991
Practice Address - Street 1:11219 FINANCIAL CENTRE PKWY STE 315
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72211-3895
Practice Address - Country:US
Practice Address - Phone:501-661-9299
Practice Address - Fax:501-661-1991
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-22
Last Update Date:2021-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR4023228001OtherCIGNA PROVIDER #
AR470000063OtherRAILROAD MEDICARE PROV #
AR5553617OtherAETNA PROVIDER #
AR342001OtherUNITED HEALTHCARE PROV #
AR342001OtherUNITED HEALTHCARE PROV #