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SOUTHSIDE MEDICAL CLINIC NPI 1194937235


NPI Information

NPI: 1194937235
Provider Name: SOUTHSIDE MEDICAL CLINIC
Classification: Internal Medicine - 207R00000X
Entity Type: Organization

CLIA Number: 04D1071452

Address:
623 S 21ST ST
FORT SMITH, AR
ZIP 72901
Phone: (479) 441-1500
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SOUTHSIDE MEDICAL CLINIC is an internal medicine in Fort Smith, AR. The provider is a physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. SOUTHSIDE MEDICAL CLINIC NPI is 1194937235. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

623 S 21ST ST
FORT SMITH, AR
ZIP 72901-914
Phone: (479) 441-1500
Fax: (479) 441-1502

The provider's authorized official is Thuylinh Pham .
The authorized official title is Ceo and has the following contact phone number (870) 424-5079.

The CLIA number assigned to this NPI record is 04D1071452 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/3/2007 and was last updated on 8/22/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207R00000XInternal MedicineE1751ARKANSASYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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