Provider Demographics
NPI:1629869904
Name:BALENTINE MEDICAL SERVICES, PLLC
Entity type:Organization
Organization Name:BALENTINE MEDICAL SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:BALENTINE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:501-258-4433
Mailing Address - Street 1:147 SUMMIT VALLEY CIR
Mailing Address - Street 2:
Mailing Address - City:MAUMELLE
Mailing Address - State:AR
Mailing Address - Zip Code:72113-6096
Mailing Address - Country:US
Mailing Address - Phone:501-258-4433
Mailing Address - Fax:229-264-5700
Practice Address - Street 1:147 SUMMIT VALLEY CIR
Practice Address - Street 2:
Practice Address - City:MAUMELLE
Practice Address - State:AR
Practice Address - Zip Code:72113-6096
Practice Address - Country:US
Practice Address - Phone:501-258-4433
Practice Address - Fax:229-264-5700
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-15
Last Update Date:2025-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty