# ARKANSAS HEALTH GROUP

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Arkansas Vascular
- **Organization subpart:** No

## Provider details

- **NPI number:** 1346317476
- **Authorized official:** TOMMY JOHNSON (PMA)
- **Authorized official phone:** (501) 812-7514

## Contact information

- **Practice address:** 9601 LILE DR STE 250, MEDICAL TOWERS 1, LITTLE ROCK, AR 72205-6355
- **Practice address phone:** (501) 227-4787
- **Mailing address:** 11001 EXECUTIVE CENTER DR, SUITE 200, LITTLE ROCK, AR 72211-4316
- **Mailing address phone:** (501) 812-7587

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2086S0129X | Vascular Surgery Physician | — | NULL | Yes |
| 2086S0129X | Vascular Surgery Physician | — | — | Yes |

## Other

- **Enumeration date:** 11/30/2006
- **Last updated:** 05/22/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 159837002 | — | AR |