Basic Information
Provider Information
NPI: 1093305369
EntityType: 2
ReplacementNPI:  
OrganizationName: CENTRAL ARKANSAS RADIATION THERAPY INSTITUTE INC
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName: CARTI THERAPY SERVICES
OtherOrganizationType: 5
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 55050
Address2:  
City: LITTLE ROCK
State: AR
PostalCode: 722155050
CountryCode: US
TelephoneNumber: 5019063000
FaxNumber: 5019076522
Practice Location
Address1: 8901 CARTI WAY
Address2:  
City: LITTLE ROCK
State: AR
PostalCode: 722056523
CountryCode: US
TelephoneNumber: 5019063000
FaxNumber: 5019076522
Other Information
ProviderEnumerationDate: 01/21/2021
LastUpdateDate: 02/03/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: STYRON
AuthorizedOfficialFirstName: JENNIFER
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: CFO/EVP
AuthorizedOfficialTelephone: 5012963232
IsSoleProprietor:  
IsOrganizationSubpart: Y
ParentOrganizationLBN: CENTRAL ARKANSAS RADIATION THERAPY INST INC
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 02/03/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
235Z00000X  N193200000X MULTI-SPECIALTY GROUPSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist 
225X00000X  Y193200000X MULTI-SPECIALTY GROUPRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist 

No ID Information.


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