Organization
ARKANSAS METHODIST HOSPITAL CORPORATION
Active
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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