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Contact Information

CRESTWOOD FOOT CLINIC, LLC
2501 CRESTWOOD RD
SUITE 101
NORTH LITTLE ROCK, AR72116-6864
 Phone: 501-771-4785
 Fax: 501-771-4785
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Podiatrist

213E00000X 48 Podiatry
Indicates primary specialty

NPI Profile & details for CRESTWOOD FOOT CLINIC, LLC

NPI Number 1962677906
LBN Legal business name CRESTWOOD FOOT CLINIC, LLC
Authorized official MARTHA JACKSON - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 04/29/2008
Last updated 07/14/2020 - About 6 years ago
Identifiers
AR License # 87
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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