Provider Demographics
NPI:1659847945
Name:ARKANSAS REGENERATIVE MEDICAL CENTER, LTD.
Entity Type:Organization
Organization Name:ARKANSAS REGENERATIVE MEDICAL CENTER, LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:HARSHFIELD
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:479-715-8011
Mailing Address - Street 1:4285 N SHILOH DR STE 104
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72703-5351
Mailing Address - Country:US
Mailing Address - Phone:479-715-8011
Mailing Address - Fax:
Practice Address - Street 1:4285 N SHILOH DR STE 104
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72703-5351
Practice Address - Country:US
Practice Address - Phone:479-715-8011
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-15
Last Update Date:2018-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes364SH1100XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistHolisticGroup - Multi-Specialty