Organization
SOUTH CENTRAL MEDICAL SERVICES, P.A.
Active
Other names
Renaissance Health and Wellness
Organization subpart
No
Provider details
NPI number
Authorized official
CHESTER L CARLSON D.O. (OWNER/MEDICAL DIRECTOR)
(479) 657-6888
Entity
Organization
Contact information
Practice address
600 AUTUMN RD, LITTLE ROCK, AR 72211-3606
(501) 448-2342
(501) 221-0615
Mailing address
PO BOX 11020, FORT SMITH, AR 72917-1020
(479) 434-4887
(479) 434-4955
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
E5307
AR
Other
Enumeration date
06/09/2014
Last updated
06/09/2014
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