University of Arkansas Medical Sciences, Ahec Pine Bluff

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Legal business name

UNIVERSITY OF ARKANSAS MEDICAL SCIENCES, AHEC PINE BLUFF

Practice address

4747 Dusty Lake Dr
Ste 203
Pine Bluff, AR 71603-8742

Phone

(870) 541-9300

NPI assigned

Oct 19, 2006

Last updated

Aug 30, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Michael Timothy Kittell, M.D.

Title

Physician

Phone

(870) 541-6000

Specialties & licenses 3

Addresses

Other identifiers 2

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1283126400000",
    "number": "1881776987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 SEZANNE CV",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722235093",
            "telephone_number": "501-821-7795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4747 DUSTY LAKE DR",
            "address_2": "STE 203",
            "city": "PINE BLUFF",
            "state": "AR",
            "postal_code": "716038742",
            "telephone_number": "870-541-9300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY OF ARKANSAS MEDICAL SCIENCES, AHEC PINE BLUFF",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-19",
        "last_updated": "2010-08-30",
        "status": "A",
        "authorized_official_last_name": "KITTELL",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "TIMOTHY",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "870-541-6000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QE0002X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Emergency Care",
            "state": "AR",
            "license": "E5801",
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "AR",
            "license": "E5801",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARKANSAS STATE MEDICAL BOARD",
            "identifier": "E-5801",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "440144201",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Univ of Ark for Med Sciences Dba Ahec Family Practice Center Indep Lab
• University of Arkansas at Pine Bluff (UAPB Sports Medicine and Rehabilitation)
• University of Arkansas for Medical Sciences (Kids First Pine Bluff)
• University of Arkansas for Medical Sciences (Justiss Lindsey Clinic AHEC)
• University of Arkansas for Medical Sciences
• Ryan Arvin Vegafria Urbano, RPT
• Urology Associates of South Arkansas
• Chizoba Usuwa, MD
• V. Bryan Perry MD PA
• Jon C Valentine, CRNA

• Student in an Organized Health Care Education/Training Program in Pine Bluff, AR
• Providers in Pine Bluff, AR by specialty
• Student in an Organized Health Care Education/Training Program in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2010; 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.