Organization
RADIOLOGISTS OF RUSSELLVILLE PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEFFREY HALE M.D. (PRESIDENT PARTNER)
(479) 968-7930
Entity
Organization
Contact information
Practice address
3301 W MAIN PL, RUSSELLVILLE, AR 72801-2334
(479) 968-7930
(479) 968-1673
Mailing address
P.O. BOX 9178, RUSSELLVILLE, AR 72811
(479) 968-7930
(479) 968-4331
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103880002
—
AR
01
—
56763
ARKANSAS BCBS
AR
Enumeration date
03/15/2006
Last updated
01/11/2019
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