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Organization
ARKANSAS HEALTH GROUP
Active
Organization
ARKANSAS HEALTH GROUP
Active
Parent organization
ARKANSAS HEALTH GROUP
Other names
Paulk Family Clinic/A Baptist Health Affiliate
Organization subpart
Yes
Provider details
NPI number
Legal business name
ARKANSAS HEALTH GROUP
Authorized official
DR. CLYDE D PAULK MD (PHYSICIAN)
(870) 942-5155
Entity
Organization
Contact information
Practice address
1110 W VINE ST, SHERIDAN, AR 72150-7804
(870) 942-5155
(870) 942-8791
Mailing address
11001 EXECUTIVE CENTER DR, SUITE 200, LITTLE ROCK, AR 72211-4316
(501) 812-7800
(501) 812-7851
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
C3204
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
128401002
—
AR
01
—
14003000000
QUALCHOICE
AR
01
—
5901655
AETNA
AR
01
—
770017602
BREASTCARE
AR
Enumeration date
03/15/2006
Last updated
02/09/2009
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