Organization
ARKANSAS RENAL GROUP PA
Active
Other names
South Arkansas Nephrology Services
Organization subpart
No
Provider details
NPI number
Authorized official
JERRY P EDGIN JR. (CEO)
(501) 624-6000
Entity
Organization
Contact information
Practice address
620 W GROVE ST, EL DORADO, AR 71730-4462
(870) 862-0801
Mailing address
115 WRIGHTS ST, HOT SPRINGS, AR 71913-6240
(501) 624-6000
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
190999002
—
AR
Enumeration date
10/21/2011
Last updated
07/27/2021
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