Basic Information
| Provider Information | |||||||||
| NPI: | 1861425415 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | HEALTHFIRST PHYSICIANS OF ARKANSAS PA | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | CONVENIENT CARE CLINIC | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 21908 | ||||||||
| Address2: | |||||||||
| City: | HOT SPRINGS | ||||||||
| State: | AR | ||||||||
| PostalCode: | 719031908 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5015205476 | ||||||||
| FaxNumber: | 5015205486 | ||||||||
| Practice Location | |||||||||
| Address1: | 1662 HIGDON FERRY ROAD | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | HOT SPRINGS | ||||||||
| State: | AR | ||||||||
| PostalCode: | 71913 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5015205476 | ||||||||
| FaxNumber: | 5015205486 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/08/2006 | ||||||||
| LastUpdateDate: | 07/30/2009 | ||||||||
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| AuthorizedOfficialLastName: | TANKERSLEY | ||||||||
| AuthorizedOfficialFirstName: | MICHAEL | ||||||||
| AuthorizedOfficialMiddleName: | T. | ||||||||
| AuthorizedOfficialTitleorPosition: | CEO-HEALTHFIRST | ||||||||
| AuthorizedOfficialTelephone: | 5015205000 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | MC2118 | AR | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.