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Contact Information

ORAL SURGERY OF CENTRAL ARKANSAS
2504 MCCAIN BLVD STE 202
NORTH LITTLE ROCK, AR72116-7612
 Phone: 501-771-7600
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Oral and Maxillofacial Surgery

261QS0112X
Indicates primary specialty

NPI Profile & details for ORAL SURGERY OF CENTRAL ARKANSAS

NPI # 1124491733
LBN Legal business name ORAL SURGERY OF CENTRAL ARKANSAS
Authorized official JOHN JOHNSON - (PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 11/04/2015
Last updated 11/04/2015 - About 11 years ago
Identifiers
AR License # 2606
AR License # 3775
AR Medicaid 200352679
AR Medicaid 202575679
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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