Organization
ARKANSAS OPEN MRI
Active
Organization
ARKANSAS OPEN MRI
Active
Other names
NORTHSIDE OPEN MRI
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DON BALLARD (CEO)
(303) 252-4363
Entity
Organization
Contact information
Practice address
2929 LAKEWOOD VILLAGE DR, NORTH LITTLE ROCK, AR 72116-8033
(501) 687-6736
(501) 687-0219
Mailing address
301 N SHACKLEFORD RD, STE B4, LITTLE ROCK, AR 72211-2882
(501) 312-9990
(501) 312-9991
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5C583
BLUE CROSS/BLUE SHIELD
AR
01
—
CJ6884
RAILROAD MEDICARE
AR
Enumeration date
06/27/2005
Last updated
08/22/2020
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