Provider Demographics
NPI:1033171467
Name:ARKANSAS PATHOLOGY ASSOCIATES PA
Entity type:Organization
Organization Name:ARKANSAS PATHOLOGY ASSOCIATES PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:STACY
Authorized Official - Middle Name:M
Authorized Official - Last Name:HARTLEIN
Authorized Official - Suffix:
Authorized Official - Credentials:MBA, CT(ASCP)
Authorized Official - Phone:501-663-4116
Mailing Address - Street 1:PO BOX 55148
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72215-5148
Mailing Address - Country:US
Mailing Address - Phone:501-663-4116
Mailing Address - Fax:501-663-4301
Practice Address - Street 1:1000 N UNIVERSITY AVE
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72207-6347
Practice Address - Country:US
Practice Address - Phone:501-663-4116
Practice Address - Fax:501-663-4301
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-03
Last Update Date:2025-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE3344207ZC0500X
ARC7738207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical PathologyGroup - Single Specialty
No207ZC0500XAllopathic & Osteopathic PhysiciansPathologyCytopathologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR137097002Medicaid
AR18009Medicare PIN
AR56910Medicare PIN