Organization
ARKANSAS METHODIST HOSPITAL CORPORATION
Active
Other names
PARAGOULD ANESTHESIA GROUP
Organization subpart
No
Provider details
NPI number
Authorized official
BARRY DAVIS (CEO)
(870) 239-7000
Entity
Organization
Contact information
Practice address
900 W KINGSHIGHWAY, PARAGOULD, AR 72450-5942
(870) 239-7000
Mailing address
925 SHERWOOD DR, LAKE BLUFF, IL 60044-2203
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1025850002
—
AR
01
—
5C489
BCBS OF ARKANSAS
AR
01
—
CD7206
RAILROAD MEDICARE
AR
Enumeration date
09/25/2006
Last updated
07/16/2021
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