Provider Demographics
NPI:1639881600
Name:ARKANSAS VASCULAR AND VEIN SPECIALISTS, PLLC
Entity Type:Organization
Organization Name:ARKANSAS VASCULAR AND VEIN SPECIALISTS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EVP CREDENTIALING
Authorized Official - Prefix:
Authorized Official - First Name:KRISTEN
Authorized Official - Middle Name:
Authorized Official - Last Name:NEHK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:501-712-2571
Mailing Address - Street 1:10310 W MARKHAM ST STE 100
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-1581
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10310 W MARKHAM ST STE 100
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-1581
Practice Address - Country:US
Practice Address - Phone:501-712-2571
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-21
Last Update Date:2022-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Multi-Specialty