FULL POTENTIAL NPI 1427379387

NPI Information

NPI: 1427379387
Provider Name: FULL POTENTIAL
Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

Address:
8109 INTERSTATE 30
LITTLE ROCK, AR
ZIP 72209
Phone: (501) 374-0360
Get Directions

FULL POTENTIAL is a primary care clinic center in Little Rock, AR. FULL POTENTIAL NPI is 1427379387. The provider is registered as an organization entity type.

The provider's business location address is:

8109 INTERSTATE 30
LITTLE ROCK, AR
ZIP 72209-840
Phone: (501) 374-0360
Fax: (501) 374-0395

The provider's authorized official is Kirk N Wilson .
The authorized official title is President/ Owner and has the following contact phone number (501) 374-0360.

The enumeration date for this NPI number is 6/15/2010 and was last updated on 12/1/2010.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QP2300X	Clinic/Center	Primary Care	27063	ARKANSAS	Yes

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	=========	MEDICAID	ARKANSAS

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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