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Contact Information

ARKANSAS PEDIATRIC CLINIC, PLLC
23157 I 30 STE 101
BRYANT, AR72022-2864
 Phone: 501-664-4117
 Fax: 501-664-1137
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pediatrics

208000000X 37 Physician/Pediatric Medicine
Indicates primary specialty

NPI Profile & details for ARKANSAS PEDIATRIC CLINIC PLLC · (Female)

NPI # 1073917274
Status Active
Credentials
Entity Individual
Enumeration date 10/17/2014
Last updated 06/10/2024 - More than a year ago
Sole proprietor 1 Not specified
Identifiers
  • AR Medicaid 148500002
  • AR Medicaid 204313002
  • AR Medicaid 213058002
  • AR Medicaid 226133002
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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