LAKESIDE WALK-IN CLINIC PLLC NPI 1205345154

NPI Information

LAKESIDE WALK-IN CLINIC PLLC is a general practice in Hot Springs, AR. LAKESIDE WALK-IN CLINIC PLLC NPI is 1205345154. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

2230 MALVERN AVE STE E
HOT SPRINGS, AR
ZIP 71901-000
Phone: (501) 781-3612
Fax: (501) 781-3618

The provider's authorized official is Ernest R Ennis .
The authorized official title is Owner and has the following contact phone number (501) 844-7020.

The CLIA number assigned to this NPI record is 04D0693601 - physician office with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 9/22/2017 and was last updated on 6/16/2018.

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:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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