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Contact Information

MAGNOLIA PEDIATRIC CLINIC, INC.
306 E MCNEIL
MAGNOLIA, AR71753-2927
 Phone: 870-234-5171
 Fax: 870-234-0507
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pediatrics

208000000X 37 Physician/Pediatric Medicine
Indicates primary specialty

NPI Profile & details for MAGNOLIA PEDIATRIC CLINIC INC · (Female)

NPI # 1396775797
Status Active
Credentials
Entity Individual
Enumeration date 07/03/2006
Last updated 02/20/2012 - About 14 years ago
Sole proprietor 1 Not specified
Identifiers
  • AR License # E2147
  • AR Medicaid 140579002
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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