Provider Demographics
NPI:1568482842
Name:SLEEP CENTERS OF ARKANSAS
Entity Type:Organization
Organization Name:SLEEP CENTERS OF ARKANSAS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOCK
Authorized Official - Middle Name:S
Authorized Official - Last Name:COBB
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:501-753-2424
Mailing Address - Street 1:2215 WILDWOOD AVE
Mailing Address - Street 2:SUITE 204
Mailing Address - City:SHERWOOD
Mailing Address - State:AR
Mailing Address - Zip Code:72120-5089
Mailing Address - Country:US
Mailing Address - Phone:501-753-2424
Mailing Address - Fax:501-753-2733
Practice Address - Street 1:4000 RICHARDS RD
Practice Address - Street 2:SUITE B
Practice Address - City:NORTH LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72117-2650
Practice Address - Country:US
Practice Address - Phone:501-255-3995
Practice Address - Fax:501-255-0172
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-20
Last Update Date:2012-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR156603741Medicaid
AR156603741Medicaid