Provider Demographics
NPI:1528218237
Name:COLON AND RECTAL ASSOCIATES OF ARKANSAS, PLLC
Entity Type:Organization
Organization Name:COLON AND RECTAL ASSOCIATES OF ARKANSAS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JANA
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:479-443-9443
Mailing Address - Street 1:3302 N. NORTH HILLS BLVD
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72703-3507
Mailing Address - Country:US
Mailing Address - Phone:479-443-9443
Mailing Address - Fax:479-443-4895
Practice Address - Street 1:3302 N. NORTH HILLS BLVD
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72703-3507
Practice Address - Country:US
Practice Address - Phone:479-443-9443
Practice Address - Fax:479-443-4895
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-30
Last Update Date:2008-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty