Provider Demographics
NPI:1659430734
Name:ANESTHESIA SPECIALISTS OF ARKANSAS
Entity Type:Organization
Organization Name:ANESTHESIA SPECIALISTS OF ARKANSAS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:
Authorized Official - Last Name:LOVETT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:501-227-7797
Mailing Address - Street 1:1415 BRECKENRIDGE DR. STE B
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72227
Mailing Address - Country:US
Mailing Address - Phone:501-227-7797
Mailing Address - Fax:501-227-7753
Practice Address - Street 1:500 S UNIVERSITY AVE STE 219
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-5304
Practice Address - Country:US
Practice Address - Phone:501-227-7797
Practice Address - Fax:501-227-7753
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-06
Last Update Date:2020-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR146112002Medicaid
AR146112002Medicaid