Provider Demographics
NPI:1265595128
Name:HEMATOLOGY ONCOLOGY SERVICES OF ARKANSAS
Entity type:Organization
Organization Name:HEMATOLOGY ONCOLOGY SERVICES OF ARKANSAS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRAD
Authorized Official - Middle Name:PATRICK
Authorized Official - Last Name:BALTZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:501-907-6444
Mailing Address - Street 1:9101 KANIS RD
Mailing Address - Street 2:FIRST FLOOR
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-6417
Mailing Address - Country:US
Mailing Address - Phone:501-907-6444
Mailing Address - Fax:501-320-3293
Practice Address - Street 1:9101 KANIS RD
Practice Address - Street 2:FIRST FLOOR
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-6417
Practice Address - Country:US
Practice Address - Phone:501-907-6444
Practice Address - Fax:501-320-3293
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-19
Last Update Date:2008-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Single Specialty