Basic Information
| Provider Information | |||||||||
| NPI: | 1649536475 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | BAPTIST HEALTH MEDICAL CENTER - LR | ||||||||
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| Mailing Information | |||||||||
| Address1: | 58 BRISTOL CT | ||||||||
| Address2: | |||||||||
| City: | LITTLE ROCK | ||||||||
| State: | AR | ||||||||
| PostalCode: | 722112164 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5012464179 | ||||||||
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| Practice Location | |||||||||
| Address1: | 9601 INTERSTATE 630 EXIT 7 | ||||||||
| Address2: | |||||||||
| City: | LITTLE ROCK | ||||||||
| State: | AR | ||||||||
| PostalCode: | 722057202 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5012022685 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/05/2012 | ||||||||
| LastUpdateDate: | 04/05/2012 | ||||||||
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| AuthorizedOfficialLastName: | BEGGS | ||||||||
| AuthorizedOfficialFirstName: | DANA | ||||||||
| AuthorizedOfficialMiddleName: | D | ||||||||
| AuthorizedOfficialTitleorPosition: | CLINICAL COORDINATOR REHAB THERAPY | ||||||||
| AuthorizedOfficialTelephone: | 5012022685 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | PT | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282N00000X | PT 244 | AR | Y | Hospitals | General Acute Care Hospital |
No ID Information.