Provider Demographics
NPI:1932119609
Name:ARKANSAS HEALTH GROUP
Entity Type:Organization
Organization Name:ARKANSAS HEALTH GROUP
Other - Org Name:BAPTIST HEALTH NEUROLOGY NORTH LITTLE ROCK
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:WILL
Authorized Official - Middle Name:
Authorized Official - Last Name:RUSHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:501-812-7500
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:501-812-7215
Mailing Address - Fax:501-812-7207
Practice Address - Street 1:505 W PERSHING BLVD
Practice Address - Street 2:SUITE C
Practice Address - City:NORTH LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72114-2147
Practice Address - Country:US
Practice Address - Phone:501-753-5723
Practice Address - Fax:501-753-7539
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-08
Last Update Date:2019-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-5989207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR160485002Medicaid
ARDG7522Medicare PIN
AR5F402Medicare PIN