# UNIVERSITY OF ARKANSAS FOR MEDICAL SCIENCES

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** UNIVERSITY OF ARKANSAS FOR MEDICAL SCIENCES
- **Other names:** Kenneth Heiles Clinic AHEC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1336184431
- **Legal business name:** UNIVERSITY OF ARKANSAS FOR MEDICAL SCIENCES
- **Authorized official:** MRS. KATHLEEN WYLIE (OFFICE MANAGER)
- **Authorized official phone:** (870) 541-6008

## Contact information

- **Practice address:** 203 S JEFFERSON ST, STAR CITY, AR 71667
- **Practice address phone:** (870) 628-5110
- **Practice address fax:** (870) 628-5949
- **Mailing address:** 4010 MULBERRY ST, PINE BLUFF, AR 71603
- **Mailing address phone:** (870) 541-6008
- **Mailing address fax:** (870) 541-6034

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 06/20/2006
- **Last updated:** 06/12/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 112297003 | — | AR |