Provider Demographics
NPI:1174940274
Name:ARKANSAS PAIN CENTERS, LTD
Entity type:Organization
Organization Name:ARKANSAS PAIN CENTERS, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BUTCHAIAH
Authorized Official - Middle Name:
Authorized Official - Last Name:GARLAPATI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:501-771-4370
Mailing Address - Street 1:308 SMOKEY LN
Mailing Address - Street 2:
Mailing Address - City:N LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72117-2508
Mailing Address - Country:US
Mailing Address - Phone:501-771-4370
Mailing Address - Fax:501-327-9722
Practice Address - Street 1:308 SMOKEY LN
Practice Address - Street 2:
Practice Address - City:N LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72117-2508
Practice Address - Country:US
Practice Address - Phone:501-771-4370
Practice Address - Fax:501-327-9722
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-26
Last Update Date:2014-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR04D1095441291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR115162002Medicaid
AR57862Medicare PIN