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Organization
BLUETAIL ARKANSAS PLLC
Active
Organization
BLUETAIL ARKANSAS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KRISTIN S OLIVER MD (OWNER)
(636) 778-2900
Entity
Organization
Contact information
Practice address
9101 KANIS RD STE 200, LITTLE ROCK, AR 72205-6455
(636) 778-2900
(636) 778-2828
Mailing address
C/O BLUETAIL MEDICAL GROUP, LLC, 17300 NORTH OUTER 40 RD, STE 201, CHESTERFIELD, MO 63005-1364
(636) 778-2900
(636) 778-2828
Taxonomy
Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
—
—
Other
Enumeration date
09/04/2018
Last updated
11/15/2018
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