1245294313 NPI number — ARTHUR HOUSTON BURNS CRNA

Table of content: ARTHUR HOUSTON BURNS CRNA (NPI 1245294313)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1245294313 NPI number — ARTHUR HOUSTON BURNS CRNA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BURNS
Provider First Name:
ARTHUR
Provider Middle Name:
HOUSTON
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
CRNA
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1245294313
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/06/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 771522
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MEMPHIS
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
38177-1522
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
901-747-4624
Provider Business Mailing Address Fax Number:
901-261-2542

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1801 MARTIN LUTHER KING JR DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HELENA
Provider Business Practice Location Address State Name:
AR
Provider Business Practice Location Address Postal Code:
72342-8998
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
870-816-3780
Provider Business Practice Location Address Fax Number:
870-816-3909
Provider Enumeration Date:
04/14/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 367500000X , with the licence number:  C00792 , registered in the state of AR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1245294313 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( AR ) . This identifiers is of the category "OTHER".
  • Identifier: 59865 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( AR ) . This identifiers is of the category "OTHER".
  • Identifier: 1245294313 . This is a "BAPTIST HEALTH SERVICES GROUP, INC" identifier , issued by the state of ( AR ) . This identifiers is of the category "OTHER".
  • Identifier: 1245294313 . This is a "TRICARE - SOUTH REGION" identifier , issued by the state of ( AR ) . This identifiers is of the category "OTHER".
  • Identifier: 124750701 , issued by the state of ( AR ) . This identifiers is of the category "MEDICAID".
  • Identifier: P00020588 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( AR ) . This identifiers is of the category "OTHER".




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