Active NPI
Russellville Gynecology Clinic
- Gynecology Physician
- Russellville, AR
National Provider Identifier
1164412243
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gynecology Physician
- License
- C4687
- Legal business name
- RUSSELLVILLE GYNECOLOGY CLINIC
- Practice address
- 914 W B St
Russellville, AR 72801-3502 - Phone
- (479) 968-7909
- Fax
- (479) 968-6908
- NPI assigned
- Oct 28, 2005
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Lawrence Douglas Battles, M.D.
- Title
- President
- Phone
- (479) 968-7909
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gynecology Physician | 207VG0400X | C4687 | AR | Primary |
Addresses
Primary practice location
914 W B St
Russellville, AR 72801-3502
Mailing address
914 W B St
Russellville, AR 72801-3502
Phone (479) 968-7909
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 13403000000 | Other | AR | QUALCHOICE NUMBER |
| 7420060 | Other | AR | UNITED HEALTHCARE NUMBER |
| 0004567368 | Other | AR | AETNA NUMBER |
National Provider Directory
National Provider DirectoryLocations
914 W B St
Russellville, AR 72801
Phone (479) 968-7909
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1130457600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1164412243",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "914 W B ST",
"city": "RUSSELLVILLE",
"state": "AR",
"postal_code": "728013502",
"telephone_number": "479-968-7909",
"fax_number": "479-968-6908"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "914 W B ST",
"city": "RUSSELLVILLE",
"state": "AR",
"postal_code": "728013502",
"telephone_number": "479-968-7909",
"fax_number": "479-968-6908"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "RUSSELLVILLE GYNECOLOGY CLINIC",
"organizational_subpart": "NO",
"enumeration_date": "2005-10-28",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "BATTLES",
"authorized_official_first_name": "LAWRENCE",
"authorized_official_middle_name": "DOUGLAS",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "479-968-7909",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "207VG0400X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Obstetrics & Gynecology, Gynecology",
"state": "AR",
"license": "C4687",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "QUALCHOICE NUMBER",
"identifier": "13403000000",
"state": "AR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE NUMBER",
"identifier": "7420060",
"state": "AR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA NUMBER",
"identifier": "0004567368",
"state": "AR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Russellville, AR
- Russellville Ear Nose and Throat Surgery Clinic, P.a.
- Russellville Eye Clinic, P.a.
- Russellville Family Clinic PA
- Russellville Family Dentistry PA
- Russellville Gastroenterology Clinic PA
- Russellville Holdings LLC
- Russellville Holdings LLC
- Russellville Holdings LLC
- Russellville Holdings LLC
- Russellville Pediatric & Adolescent Clinic, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.