Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Bluetail Arkansas PLLC

Organization Sports Medicine (Family Medicine) Physician · NPI 1578045803

Bluetail Arkansas PLLC is a Sports Medicine (Family Medicine) Physician in Little Rock, Arkansas. Registered with an NPI since 2018.

In the registry since
2018
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

9101 Kanis Rd Ste 200
Little Rock, AR 72205-6455
Phone: (636) 778-2900
Fax: (636) 778-2828
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Sports Medicine (Family Medicine) Physician (primary) Taxonomy 207QS0010X

Record details

NPI number1578045803
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Kristin Oliver — Owner · (636) 778-2900
NPI enumeratedSeptember 4, 2018
Last updated in NPPESNovember 15, 2018
Mailing addressC/O Bluetail Medical Group, Llc, 17300 North Outer 40 Rd, Ste 201, Chesterfield, MO 63005-1364

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