| Bluetail Arkansas Pllc | |
|
9101 Kanis Rd Ste 200 Little Rock AR 72205-6455 | |
| (636) 778-2900 | |
| (636) 778-2828 |
| Full Name | Bluetail Arkansas Pllc |
|---|---|
| Speciality | Family Medicine - Sports Medicine |
| Location | 9101 Kanis Rd Ste 200, Little Rock, Arkansas |
| Authorized Official Name and Position | Kristin S Oliver (OWNER) |
| Authorized Official Contact | 6367782900 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bluetail Arkansas Pllc C/o Bluetail Medical Group, Llc 17300 North Outer 40 Rd, Ste 201 Chesterfield MO 63005-1364 Ph: (636) 778-2900 | Bluetail Arkansas Pllc 9101 Kanis Rd Ste 200 Little Rock AR 72205-6455 Ph: (636) 778-2900 |
| NPI Number | 1578045803 |
|---|---|
| Provider Enumeration Date | 09/04/2018 |
| Last Update Date | 11/15/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578045803 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QS0010X | Family Medicine - Sports Medicine | (* (Not Available)) | Primary |
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