National Provider Identifier Database

GREAT RIVER PEDIATRIC CLINIC
Pediatrics

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.


Contact Information

GREAT RIVER PEDIATRIC CLINIC
1521 N 10TH ST
STE F
BLYTHEVILLE, AR72315-1405
Phone: 870-780-6832
Fax: 870-780-6919
Website:
Specialty Taxonomy Code
* Pediatrics 208000000X

* Indicates primary specialty

NPI Profile & details for GREAT RIVER PEDIATRIC CLINIC

NPI Number 1467586131
Legal business name
LBN
GREAT RIVER PEDIATRIC CLINIC
Authorized official BENJAMIN ASAFO-BOAKYE - (PEDIATRICIAN)
Entity Organization
Organization subpart No
Enumeration date 03/15/2007
Last updated 08/22/2020 - About 6 years ago
Sole proprietor1 Not specified
Identifiers
  • AR License #: E-4133
  • AR Other: 5F511 BLUE CROSS BLUE SHIELD

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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