Organization Name: | SOUTH ARKANSAS PHYSICIAN SERVICES, LLC |
NPI Number: | 1821023292 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | V KAREN FLINN (VP) |
Mailing Address: | 714 W Faulkner St El Dorado |
State: | AR US |
Postal Code: | 717304598 |
Phone Number: | 8708632516 |
Fax Number: | |
NPI Enumeration Date: | 07/12/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |