Provider Demographics
NPI:1598874596
Name:ARKANSAS SPINE & SPORTS INSTITIUTE
Entity Type:Organization
Organization Name:ARKANSAS SPINE & SPORTS INSTITIUTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DEBBIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MASON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:501-821-7768
Mailing Address - Street 1:25 RAHLING CIR
Mailing Address - Street 2:SUITE A
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72223-9194
Mailing Address - Country:US
Mailing Address - Phone:501-821-7768
Mailing Address - Fax:501-821-4014
Practice Address - Street 1:25 RAHLING CIR
Practice Address - Street 2:SUITE A
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72223-9194
Practice Address - Country:US
Practice Address - Phone:501-821-7768
Practice Address - Fax:501-821-4014
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARMC-2071261QR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR5C518Medicare ID - Type Unspecified