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Contact Information

CONWAY PSYCHIATRIC CLINIC, PLLC
5330 PLANTATION CV
CONWAY, AR72034-8586
 Phone: 501-472-7697
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Psychiatry

2084P0800X 26 Physician/Psychiatry
Indicates primary specialty

NPI Profile & details for CONWAY PSYCHIATRIC CLINIC, PLLC

NPI # 1972808145
LBN Legal business name CONWAY PSYCHIATRIC CLINIC, PLLC
Authorized official RAYMOND CLARK - (DOCTOR)
Entity Organization
Organization subpart 1 No
Enumeration date 01/20/2011
Last updated 01/20/2011 - About 15 years ago
Identifiers
AR License # C-8236
AR Medicaid 129952001
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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