Provider Demographics
NPI:1104049048
Name:WILLIAM J. HELMS, MD PA
Entity type:Organization
Organization Name:WILLIAM J. HELMS, MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:PATTI
Authorized Official - Middle Name:
Authorized Official - Last Name:PIERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:269-491-3263
Mailing Address - Street 1:PO BOX 3221
Mailing Address - Street 2:
Mailing Address - City:RUSSELLVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72811-3221
Mailing Address - Country:US
Mailing Address - Phone:479-968-8940
Mailing Address - Fax:
Practice Address - Street 1:2210 W MAIN ST
Practice Address - Street 2:
Practice Address - City:RUSSELLVILLE
Practice Address - State:AR
Practice Address - Zip Code:72801-2760
Practice Address - Country:US
Practice Address - Phone:479-968-8940
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-10
Last Update Date:2021-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARC8266174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR134886002Medicaid