Organization
SIGNATURE MEDICAL PARK HOSPITAL LLC
Active
Other names
Medical Park Doctors Group
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TODD LORENZ (CEO)
(870) 722-2400
Entity
Organization
Contact information
Practice address
2001 S MAIN ST, HOPE, AR 71801-8124
(870) 722-7231
(870) 722-7192
Mailing address
PO BOX 601, HOPE, AR 71802-0601
(870) 722-7231
(870) 722-7192
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
363LW0102X
Women's Health Nurse Practitioner
—
—
367A00000X
Advanced Practice Midwife
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5F528
BCBS
AR
Enumeration date
06/15/2006
Last updated
12/07/2007
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