Provider Demographics
NPI:1689839961
Name:ARKANSAS HEALTH GROUP
Entity Type:Organization
Organization Name:ARKANSAS HEALTH GROUP
Other - Org Name:PHYSICAL MEDICINE AND REHABILITATION/A BAPTIST HEALTH AFFILIATE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:REGIONAL PRACTICE ADMINSTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:
Authorized Official - Last Name:HYATT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:501-812-7587
Mailing Address - Street 1:11001 EXECUTIVE CENTER DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72211-4316
Mailing Address - Country:US
Mailing Address - Phone:501-812-7587
Mailing Address - Fax:
Practice Address - Street 1:9600 LILE DR
Practice Address - Street 2:SUITE 210
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-6326
Practice Address - Country:US
Practice Address - Phone:501-202-4784
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-25
Last Update Date:2010-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273Y00000XHospital UnitsRehabilitation Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR174985002Medicaid
AR5G087Medicare PIN
ARCH1933Medicare PIN