# MIDSOUTH TRANSITIONS ARKANSAS PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1003427873
- **Authorized official:** COY WILLIAMSON (COO)
- **Authorized official phone:** (430) 200-4350

## Contact information

- **Practice address:** 6010 TRINITY HTS, TEXARKANA, AR 71854-8318
- **Practice address phone:** (430) 200-4350
- **Practice address fax:** (833) 491-2722
- **Mailing address:** 5904 SUMMERFIELD DR, TEXARKANA, TX 75503-4306
- **Mailing address phone:** (430) 200-4350
- **Mailing address fax:** (866) 337-1615

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 133V00000X | Registered Dietitian | — | NULL | — |
| 133V00000X | Registered Dietitian | — | — | — |
| 207QG0300X | Geriatric Medicine (Family Medicine) Physician | — | NULL | — |
| 207QG0300X | Geriatric Medicine (Family Medicine) Physician | — | — | — |
| 207R00000X | Internal Medicine Physician | — | NULL | Yes |
| 207R00000X | Internal Medicine Physician | — | — | Yes |
| 225100000X | Physical Therapist | — | NULL | — |
| 225100000X | Physical Therapist | — | — | — |
| 363LF0000X | Family Nurse Practitioner | — | NULL | — |
| 363LF0000X | Family Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 08/13/2020
- **Last updated:** 11/14/2023