South Central Medical Services, P.a.

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

E5307 Issued in AR

Legal business name

SOUTH CENTRAL MEDICAL SERVICES, P.A.

Practice address

600 Autumn Rd
Little Rock, AR 72211-3606

Phone

(501) 448-2342

Fax

(501) 221-0615

NPI assigned

Jun 9, 2014

Organization subpart

No

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

Authorized official

Name

Chester L Carlson, D.O.

Title

Owner/Medical Director

Phone

(479) 657-6888

Specialties & licenses 1

Addresses

Other names 1

• Renaissance Health and Wellness Doing business as

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

{
    "created_epoch": "1402272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1402272000000",
    "number": "1497168397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11020",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729171020",
            "telephone_number": "479-434-4887",
            "fax_number": "479-434-4955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 AUTUMN RD",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722113606",
            "telephone_number": "501-448-2342",
            "fax_number": "501-221-0615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH CENTRAL MEDICAL SERVICES, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-09",
        "last_updated": "2014-06-09",
        "status": "A",
        "authorized_official_last_name": "CARLSON",
        "authorized_official_first_name": "CHESTER",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER/MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "479-657-6888",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "AR",
            "license": "E5307",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Renaissance Health and Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Gary T. Souheaver, PH.D.
• Jessica Leigh Soule, LCSW
• Neil Soules
• Izoumroud Osmanovna Soultanova, MD, PH.D
• Soulutions Therapy and Coaching Services LLC
• Abigail Washispack Southard, MD
• Lisa K Southerland
• Southern Carrier Services
• Southern Legacy of Life
• Southern Mobility Inc.

• General Practice Physician in Little Rock, AR
• Providers in Little Rock, AR by specialty
• General Practice Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2014; 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.