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COLLEGE PARK FAMILY CLINIC PA NPI 1861478232


NPI Information

NPI: 1861478232
Provider Name: COLLEGE PARK FAMILY CLINIC PA
Classification: Emergency Medicine - 207P00000X
Entity Type: Organization
Address:
2511-A COLLEGE AVE
CONWAY, AR
ZIP 72034
Phone: (501) 327-6041
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COLLEGE PARK FAMILY CLINIC PA is an emergency medicine in Conway, AR. The provider is an emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. COLLEGE PARK FAMILY CLINIC PA NPI is 1861478232. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

2511-A COLLEGE AVE
CONWAY, AR
ZIP 72034
Phone: (501) 327-6041
Fax: (501) 327-6043

The provider's authorized official is Gil E Johnson .
The authorized official title is Ceo President and has the following contact phone number (501) 327-6041.

The enumeration date for this NPI number is 12/19/2005 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
1207P00000XEmergency MedicineC6340ARKANSASYes
2207Q00000XFamily MedicineC6340ARKANSASX
3208000000XPediatricsC6340ARKANSASX

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
111451000000OTHERARKANSASQC

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: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.