| NPI | 1275922833 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SIDNEY HOLLIS SIMPSON Owner President 479-394-3540 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: AR 963) |
| Enumeration Date | 2015-01-20 |
| Last Update Date | 2015-02-17 |