Provider Demographics
NPI:1538132402
Name:ARKANSAS HEALTH GROUP
Entity Type:Organization
Organization Name:ARKANSAS HEALTH GROUP
Other - Org Name:OUACHITA VALLEY FAMILY PRACTICE/A BAPTIST AFFILIATE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:WILL
Authorized Official - Middle Name:
Authorized Official - Last Name:RUSHER
Authorized Official - Suffix:
Authorized Official - Credentials:CEO
Authorized Official - Phone:501-812-7500
Mailing Address - Street 1:PO BOX 757
Mailing Address - Street 2:
Mailing Address - City:CAMDEN
Mailing Address - State:AR
Mailing Address - Zip Code:71711-0757
Mailing Address - Country:US
Mailing Address - Phone:870-836-8101
Mailing Address - Fax:870-837-6833
Practice Address - Street 1:353 CASH RD SW
Practice Address - Street 2:
Practice Address - City:CAMDEN
Practice Address - State:AR
Practice Address - Zip Code:71701-3704
Practice Address - Country:US
Practice Address - Phone:870-836-8101
Practice Address - Fax:870-837-6833
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-09
Last Update Date:2023-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR128619002Medicaid
AR5B779OtherBLUE CROSS BLUE SHIELD
AR770001002OtherBREASTCARE
AR5B779Medicare PIN
AR128619002Medicaid
AR0904380011Medicare NSC