Provider Demographics
NPI:1598843989
Name:ARKANSAS SPECIALTY RADIOLOGY, PLLC
Entity Type:Organization
Organization Name:ARKANSAS SPECIALTY RADIOLOGY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:BECK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:501-425-3537
Mailing Address - Street 1:1115 WEST 3RD STREET
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72201-2007
Mailing Address - Country:US
Mailing Address - Phone:501-687-9099
Mailing Address - Fax:501-687-9276
Practice Address - Street 1:1115 WEST 3RD STREET
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72201-2007
Practice Address - Country:US
Practice Address - Phone:501-687-9099
Practice Address - Fax:501-687-9276
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2014-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR5F620Medicare ID - Type UnspecifiedMEDICARE GROUP NUMBER