Organization
ARKANSAS RENAL GROUP PA
Active
Parent organization
ARKANSAS RENAL GROU PA
Other names
Russellville Nephrology
Organization subpart
Yes
Provider details
NPI number
Legal business name
ARKANSAS RENAL GROU PA
Authorized official
JERRY EDGIN CPA (CHIEF EXECUTIVE OFFICER)
(501) 624-6000
Entity
Organization
Contact information
Practice address
111 SKYLINE DR, RUSSELLVILLE, AR 72801-3363
(501) 624-6000
(501) 321-0710
Mailing address
115 WRIGHTS ST STE C, HOT SPRINGS, AR 71913-6240
(501) 624-6000
(501) 321-0710
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
—
—
Other
Enumeration date
01/07/2022
Last updated
01/07/2022
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