Provider Demographics
NPI:1700311222
Name:ARKANSAS HEALTH GROUP
Entity Type:Organization
Organization Name:ARKANSAS HEALTH GROUP
Other - Org Name:BAPTIST HEALTH PEDIATRIC CLINIC CONWAY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:WILL
Authorized Official - Middle Name:
Authorized Official - Last Name:RUSHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:501-812-7503
Mailing Address - Street 1:11001 EXCECUTIVE CENTER DRIVE
Mailing Address - Street 2:200
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72211-4393
Mailing Address - Country:US
Mailing Address - Phone:501-358-6892
Mailing Address - Fax:501-358-6894
Practice Address - Street 1:625 UNITED DR STE 410
Practice Address - Street 2:
Practice Address - City:CONWAY
Practice Address - State:AR
Practice Address - Zip Code:72032-7810
Practice Address - Country:US
Practice Address - Phone:501-358-6892
Practice Address - Fax:501-358-6894
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-21
Last Update Date:2023-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center