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Contact Information

COLLEGE PARK FAMILY CLINIC PA
2511-A COLLEGE AVE
CONWAY, AR72034
 Phone: 501-327-6041
 Fax: 501-327-6043
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Emergency Medicine

207P00000X 93 Physician/Emergency Medicine
 

Family Medicine

207Q00000X 08 Physician/Family Practice
 

Pediatrics

208000000X 37 Physician/Pediatric Medicine
Indicates primary specialty

NPI Profile & details for COLLEGE PARK FAMILY CLINIC PA

NPI # 1861478232
LBN Legal business name COLLEGE PARK FAMILY CLINIC PA
Authorized official GIL JOHNSON - (CEO PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 12/19/2005
Last updated 09/11/2025 - About 9 months ago
Identifiers
AR License # C6340
AR Other 11451000000 QC
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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