Provider Demographics
NPI:1144876418
Name:ARKMED HEALTHCARE ASSOCIATES, PLLC
Entity type:Organization
Organization Name:ARKMED HEALTHCARE ASSOCIATES, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:BROCK
Authorized Official - Middle Name:HARRISON
Authorized Official - Last Name:WRINKLES
Authorized Official - Suffix:
Authorized Official - Credentials:PA-C
Authorized Official - Phone:501-599-8400
Mailing Address - Street 1:PO BOX 3751
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72203-3751
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1801 CENTRAL AVE STE A
Practice Address - Street 2:
Practice Address - City:HOT SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:71901-6800
Practice Address - Country:US
Practice Address - Phone:501-623-5598
Practice Address - Fax:501-623-5516
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-13
Last Update Date:2023-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction MedicineGroup - Single Specialty
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary CareGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR220675795Medicaid
ARPA-720OtherARKANSAS STATE MEDICAL BOARD
1139067OtherNCCPA