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HARRISON PEDIATRICS NPI 1467817148


NPI Information

NPI: 1467817148
Provider Name: HARRISON PEDIATRICS
Classification: Preferred Provider Organization - 305R00000X
Entity Type: Organization

CLIA Number: 04D0690634

Address:
1418 MCCOY DR
HARRISON, AR
ZIP 72601
Phone: (870) 391-5903
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HARRISON PEDIATRICS is a preferred provider organization in Harrison, AR. The provider is a group of physicians and/or hospitals who contract with an employer to provide services to their employees. In a PPO, the patient may got to the physician of his/her choice, even if that physician does not participate in the PPO, but the patient receives care at a lower benefit level. HARRISON PEDIATRICS NPI is 1467817148. The provider is registered as an organization entity type.

The provider's business location address is:

1418 MCCOY DR
HARRISON, AR
ZIP 72601-411
Phone: (870) 391-5903
Fax: (870) 743-4641

The provider's authorized official is Soma Ghosh .
The authorized official title is Office Manager and has the following contact phone number (870) 391-5903.

The CLIA number assigned to this NPI record is 04D0690634 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/22/2015 and was last updated on 12/22/2015.


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
1305R00000XPreferred Provider OrganizationMC-3097ARKANSASYes

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
1210549002MEDICAIDARKANSAS

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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