# SOUTH CENTRAL MEDICAL SERVICES PA

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

## Provider details

- **NPI number:** 1841530318
- **Authorized official:** DR. CHESTER L. CARLSON D.O. (PRESIDENT)
- **Authorized official phone:** (501) 551-3556

## Contact information

- **Practice address:** 5212 VILLAGE PKWY, SUITE 2, ROGERS, AR 72758-8104
- **Practice address phone:** (479) 657-6888
- **Practice address fax:** (479) 434-5572
- **Mailing address:** 701 S 21ST ST, FORT SMITH, AR 72901-4001
- **Mailing address phone:** (501) 551-3556
- **Mailing address fax:** (800) 861-7171

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 261QP2300X | Primary Care Clinic/Center | MC-2949 | AR | — |
| 363LA2200X | Adult Health Nurse Practitioner | — | NULL | — |
| 363LA2200X | Adult Health Nurse Practitioner | — | — | — |
| 363LF0000X | Family Nurse Practitioner | — | NULL | — |
| 363LF0000X | Family Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 02/21/2013
- **Last updated:** 03/16/2013