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LITTLE ROCK ALLERGY & ASTHMA CLINIC PA NPI 1154360576


NPI Information

NPI: 1154360576
Provider Name: LITTLE ROCK ALLERGY & ASTHMA CLINIC PA
Classification: Allergy & Immunology - 207K00000X
Entity Type: Organization

CLIA Number: 04D1032600

Address:
18 CORPORATE HILL DR
SUITE 110
LITTLE ROCK, AR
ZIP 72205
Phone: (501) 224-1156
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LITTLE ROCK ALLERGY & ASTHMA CLINIC PA is an allergy immunology in Little Rock, AR. The provider is an allergist-immunologist is trained in evaluation, physical and laboratory diagnosis, and management of disorders involving the immune system. Selected examples of such conditions include asthma, anaphylaxis, rhinitis, eczema, and adverse reactions to drugs, foods, and insect stings as well as immune deficiency diseases (both acquired and congenital), defects in host defense, and problems related to autoimmune disease, organ transplantation, or malignancies of the immune system. LITTLE ROCK ALLERGY & ASTHMA CLINIC PA NPI is 1154360576. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

18 CORPORATE HILL DR
SUITE 110
LITTLE ROCK, AR
ZIP 72205-565
Phone: (501) 224-1156
Fax: (501) 801-5561

The provider's authorized official is Jennifer Wake .
The authorized official title is Operations Manager and has the following contact phone number (501) 978-7113.

The CLIA number assigned to this NPI record is 04D1032600 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/5/2006 and was last updated on 10/16/2014.


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
1207K00000XAllergy & ImmunologyMC0750ARKANSASYes

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
1104919002MEDICAIDARKANSAS
257426MEDICARE ID-TYPE UNSPECIFIEDARKANSAS

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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