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SALINE MED-PEDS GROUP INC NPI 1396820437


NPI Information

NPI: 1396820437
Provider Name: SALINE MED-PEDS GROUP, INC
Classification: Pediatrics - 208000000X
Entity Type: Organization

CLIA Number: 04D0979586

Address:
105 MCNEIL ST
BENTON, AR
ZIP 72015
Phone: (501) 315-1222
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SALINE MED-PEDS GROUP, INC is a pediatrics in Benton, AR. The provider is 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. SALINE MED-PEDS GROUP, INC NPI is 1396820437. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

105 MCNEIL ST
BENTON, AR
ZIP 72015-345
Phone: (501) 315-1222
Fax: (501) 315-1241

The provider's authorized official is Mark A Martindale .
The authorized official title is Owner and has the following contact phone number (501) 315-1222.

The CLIA number assigned to this NPI record is 04D0979586 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 10/26/2006 and was last updated on 4/28/2023.


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 MedicineC7310ARKANSASNo
2207R00000XInternal MedicineNo
3208000000XPediatricsE5062ARKANSASNo
4208000000XPediatricsC7310ARKANSASNo
5208D00000XGeneral PracticeC2718ARKANSASNo
6208D00000XGeneral PracticeNo
7208000000XPediatricsYes

Other Identifiers

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

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1161473002MEDICAIDARKANSAS

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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