Organization Active NPI

Univ of Ark for Med Sciences Dba Ahec Family Practice Center Indep Lab

  • Family Medicine Physician
  • Pine Bluff, AR
National Provider Identifier
1477571933
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
UNIV OF ARK FOR MED SCIENCES DBA AHEC FAMILY PRACTICE CENTER INDEP LAB
Practice address
4010 S Mulberry St
Pine Bluff, AR 71603-7000
Phone
(870) 541-6008
Fax
(870) 541-6034
NPI assigned
Jul 17, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Kathleen Wylie
Title
Office Manager
Phone
(870) 541-6008

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

4010 S Mulberry St
Pine Bluff, AR 71603-7000

Mailing address

4010 S Mulberry St
Pine Bluff, AR 71603-7000
Phone (870) 541-6008

National Provider Directory

National Provider Directory
Tax ID family
Karen Atkin111 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1477571933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4010 S MULBERRY ST",
            "city": "PINE BLUFF",
            "state": "AR",
            "postal_code": "716037000",
            "telephone_number": "870-541-6008",
            "fax_number": "870-541-6034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4010 S MULBERRY ST",
            "city": "PINE BLUFF",
            "state": "AR",
            "postal_code": "716037000",
            "telephone_number": "870-541-6008",
            "fax_number": "870-541-6034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIV OF ARK FOR MED SCIENCES DBA AHEC FAMILY PRACTICE CENTER INDEP LAB",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WYLIE",
        "authorized_official_first_name": "KATHLEEN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "870-541-6008",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pine Bluff, AR

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.

Verify at the official NPI Registry.