Organization
UNIVERSITY OF ARKANSAS FOR MEDICAL SCIENCES
Active
Parent organization
UNIVERSITY OF ARKANSAS FOR MEDICAL SCIENCES
Other names
Kenneth Heiles Clinic AHEC
Organization subpart
Yes
Provider details
NPI number
Legal business name
UNIVERSITY OF ARKANSAS FOR MEDICAL SCIENCES
Authorized official
MRS. KATHLEEN WYLIE (OFFICE MANAGER)
(870) 541-6008
Entity
Organization
Contact information
Practice address
203 S JEFFERSON ST, STAR CITY, AR 71667
(870) 628-5110
(870) 628-5949
Mailing address
4010 MULBERRY ST, PINE BLUFF, AR 71603
(870) 541-6008
(870) 541-6034
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
112297003
—
AR
Enumeration date
06/20/2006
Last updated
06/12/2008
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