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MAGNOLIA PEDIATRIC CLINIC INC. NPI 1396775797


NPI Information

NPI: 1396775797
Provider Name: MAGNOLIA PEDIATRIC CLINIC, INC.
Classification: Pediatrics - 208000000X
Entity Type: Organization
Address:
306 E MCNEIL
MAGNOLIA, AR
ZIP 71753
Phone: (870) 234-5171
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MAGNOLIA PEDIATRIC CLINIC, INC. is a pediatrics in Magnolia, AR. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. MAGNOLIA PEDIATRIC CLINIC, INC. NPI is 1396775797. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

306 E MCNEIL
MAGNOLIA, AR
ZIP 71753-927
Phone: (870) 234-5171
Fax: (870) 234-0507

The provider's authorized official is Amy Cross .
The authorized official title is Owner/president and has the following contact phone number (870) 234-5171.

The enumeration date for this NPI number is 7/3/2006 and was last updated on 2/20/2012.


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
1208000000XPediatricsE2147ARKANSASYes

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
1140579002MEDICAIDARKANSAS

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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