# SOUTH CENTRAL MEDICAL SERVICES, P.A.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Renaissance Health and Wellness
- **Organization subpart:** No

## Provider details

- **NPI number:** 1497168397
- **Authorized official:** CHESTER L CARLSON D.O. (OWNER/MEDICAL DIRECTOR)
- **Authorized official phone:** (479) 657-6888

## Contact information

- **Practice address:** 600 AUTUMN RD, LITTLE ROCK, AR 72211-3606
- **Practice address phone:** (501) 448-2342
- **Practice address fax:** (501) 221-0615
- **Mailing address:** PO BOX 11020, FORT SMITH, AR 72917-1020
- **Mailing address phone:** (479) 434-4887
- **Mailing address fax:** (479) 434-4955

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | E5307 | AR | Yes |

## Other

- **Enumeration date:** 06/09/2014
- **Last updated:** 06/09/2014