PHYSICIAN'S MANAGEMENT GROUP NPI 1871756437

NPI Information

NPI: 1871756437
Provider Name: PHYSICIAN'S MANAGEMENT GROUP
Classification: Psychologist - 103TM1800X
Entity Type: Organization

Specialization: Intellectual and Developmental Disabilities

CLIA Number: 04D2042678

Address:
2520 W MAIN ST
JACKSONVILLE, AR
ZIP 72076
Phone: (501) 982-0528
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PHYSICIAN'S MANAGEMENT GROUP is an intellectual and developmental disabilities in Jacksonville, AR. PHYSICIAN'S MANAGEMENT GROUP NPI is 1871756437. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

2520 W MAIN ST
JACKSONVILLE, AR
ZIP 72076-214
Phone: (501) 982-0528
Fax: (501) 985-7777

The provider's authorized official is Robert Farrell .
The authorized official title is Ceo and has the following contact phone number (501) 663-4204.

The CLIA number assigned to this NPI record is 04D2042678 - independent with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 7/3/2008 and was last updated on 7/3/2008.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	103TM1800X	Psychologist	Intellectual and Developmental Disabilities	C5129	ARKANSAS	Yes

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

NPI Synchronization or Removal

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