Organization
RADIOLOGY CONSULTANTS OF NORTHWEST ARKANSAS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KERRI COUCH (MANAGER)
(479) 968-8279
Entity
Organization
Contact information
Practice address
3205 W MAIN ST, RUSSELLVILLE, AR 72801-2301
(479) 968-8279
(479) 968-4331
Mailing address
P.O. BOX 9178, RUSSELLVILLE, AR 72801
(479) 968-8279
(479) 968-4331
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
57672
BCBS OR ARKANSAS
AR
Enumeration date
05/04/2007
Last updated
08/22/2020
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