# ARKANSAS HEALTH GROUP

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** ARKANSAS HEALTH GROUP
- **Other names:** Paulk Family Clinic/A Baptist Health Affiliate
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1548239247
- **Legal business name:** ARKANSAS HEALTH GROUP
- **Authorized official:** DR. CLYDE D PAULK MD (PHYSICIAN)
- **Authorized official phone:** (870) 942-5155

## Contact information

- **Practice address:** 1110 W VINE ST, SHERIDAN, AR 72150-7804
- **Practice address phone:** (870) 942-5155
- **Practice address fax:** (870) 942-8791
- **Mailing address:** 11001 EXECUTIVE CENTER DR, SUITE 200, LITTLE ROCK, AR 72211-4316
- **Mailing address phone:** (501) 812-7800
- **Mailing address fax:** (501) 812-7851

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | C3204 | AR | Yes |

## Other

- **Enumeration date:** 03/15/2006
- **Last updated:** 02/09/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 128401002 | — | AR |
| 01 | — | 14003000000 | QUALCHOICE | AR |
| 01 | — | 5901655 | AETNA | AR |
| 01 | — | 770017602 | BREASTCARE | AR |