Organization
PRIME MEDICAL GROUP PLLC
Active
Organization
PRIME MEDICAL GROUP PLLC
Active
Parent organization
PRIME MEDICAL GROUP PLLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
PRIME MEDICAL GROUP PLLC
Authorized official
RAY KOHLER PARKER (PHYSICIAN)
(501) 227-8422
Entity
Organization
Contact information
Practice address
1416 W 43RD AVE, PINE BLUFF, AR 71603-7010
(870) 535-7477
(870) 535-4121
Mailing address
9601 BAPTIST HEALTH DR STE 690, LITTLE ROCK, AR 72205-6328
(501) 227-8422
(501) 537-2399
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2399040002
—
AR
Enumeration date
10/20/2020
Last updated
10/20/2020
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