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Organization
SIGNATURE MEDICAL PARK HOSPITAL LLC
Active
Organization
SIGNATURE MEDICAL PARK HOSPITAL LLC
Active
Other names
Medical Park Doctors Group
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TODD LORENZ (CEO)
(870) 722-2400
Entity
Organization
Contact information
Practice address
2001 S MAIN ST, HOPE, AR 71801-8124
(870) 722-7231
(870) 722-7192
Mailing address
PO BOX 601, HOPE, AR 71802-0601
(870) 722-7231
(870) 722-7192
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
NULL
207R00000X
Internal Medicine Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
NULL
207V00000X
Obstetrics & Gynecology Physician
—
—
363LW0102X
Women's Health Nurse Practitioner
—
NULL
363LW0102X
Women's Health Nurse Practitioner
—
—
367A00000X
Advanced Practice Midwife
—
NULL
367A00000X
Advanced Practice Midwife
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5F528
BCBS
AR
Enumeration date
06/15/2006
Last updated
12/07/2007
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