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SHILOH CLINIC PLC NPI 1700188117


NPI Information

NPI: 1700188117
Provider Name: SHILOH CLINIC PLC
Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 04D2019191

Address:
307 N MAIN ST
APT. B
SPRINGDALE, AR
ZIP 72764
Phone: (479) 361-8694
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SHILOH CLINIC PLC is a family medicine in Springdale, AR. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. SHILOH CLINIC PLC NPI is 1700188117. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

307 N MAIN ST
APT. B
SPRINGDALE, AR
ZIP 72764-340
Phone: (479) 361-8694
Fax: (479) 361-8694

The provider's authorized official is William C Kendrick .
The authorized official title is Owner-partner and has the following contact phone number (479) 419-9902.

The CLIA number assigned to this NPI record is 04D2019191 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/18/2010 and was last updated on 11/18/2010.


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
1207Q00000XFamily MedicineYes

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
1E16746MEDICARE UPINARKANSAS
2D75067MEDICARE UPINARKANSAS
3103290001MEDICAIDARKANSAS
4124288001MEDICAIDARKANSAS

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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