| NPI | 1881776987 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL TIMOTHY KITTELL Physician 870-541-6000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 261QE0002X Clinic/Center, Emergency Care (Licence: AR E5801) |
| 261QP2300X Clinic/Center, Primary Care (Licence: AR E5801) | |
| Enumeration Date | 2006-10-19 |
| Last Update Date | 2010-08-30 |