Organization
SALINE PHYSICIAN SERVICES, LLC
Active
Parent organization
SALINE COUNTY MEDICAL SYSTEM
Other names
Saline Surgical Associates
Organization subpart
Yes
Provider details
NPI number
Legal business name
SALINE COUNTY MEDICAL SYSTEM
Authorized official
MRS. KIMBERLY A TITSWORTH (DIRECTOR, PHYSICIAN SERVICES)
(501) 776-6093
Entity
Organization
Contact information
Practice address
5 MEDICAL PARK DR, SUITE GL2, BENTON, AR 72015-3729
(501) 778-4862
(501) 778-4685
Mailing address
5 MEDICAL PARK DR, SUITE GL2, BENTON, AR 72015-3729
(501) 778-4862
(501) 778-4685
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1558678276
BCBS
AR
Enumeration date
09/01/2010
Last updated
10/09/2013
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