Organization · NPI-2

Midsouth Transitions Arkansas PA

Internal Medicine · Texarkana, AR

NPI number1003427873

StatusActive

Last updated in NPPESNov 14, 2023

Details

NPI: 1003427873
Entity type: Organization (NPI-2)
Legal business name: Midsouth Transitions Arkansas PA
Organization subpart: No
Enumeration date: Aug 13, 2020
Certification date: Nov 14, 2023
Last updated: Nov 14, 2023

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
207R00000X	Internal Medicine	–	–	Yes
133V00000X	Dietitian, Registered	–	–
207QG0300X	Family Medicine, Geriatric Medicine	–	–
225100000X	Physical Therapist	–	–
363LF0000X	Nurse Practitioner, Family	–	–

Practice location

6010 Trinity Hts
Texarkana, AR 71854-8318

Phone 430-200-4350 · Fax 833-491-2722

Mailing address

5904 Summerfield Dr
Texarkana, TX 75503-4306

Phone 430-200-4350 · Fax 866-337-1615

Authorized official

Coy Williamson
Coo
4302004350

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