ROBERT FREDERICK NOONAN JR MD PA NPI 1477512127

NPI Information

  • NPI: 1477512127
  • Provider Name: ROBERT FREDERICK NOONAN JR MD PA
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Organization
  • Doing Business As: CLARKSVILLE FAMILY MEDICAL CENTER
  • CLIA Number: 04D0970176
  • Address: 25 PROFESSIONAL PARK DR
    CLARKSVILLE, AR
    ZIP 72830
  • Phone: (479) 705-8181

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NPI Details

ROBERT FREDERICK NOONAN JR MD PA is a family medicine in Clarksville, AR. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. ROBERT FREDERICK NOONAN JR MD PA NPI is 1477512127. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Clarksville Family Medical Center.

The provider's business location address is:

25 PROFESSIONAL PARK DR
CLARKSVILLE, AR
ZIP 72830-432
Phone: (479) 705-8181
Fax: (479) 705-0041

The provider's authorized official is Robert Noonan .
The authorized official title is Owner and has the following contact phone number (479) 705-8181.

The CLIA number assigned to this NPI record is 04D0970176 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 3/21/2006 and was last updated on 3/26/2014.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily MedicineYes

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
15F726OTHERARKANSASBLUE CROSS
2139044002MEDICAIDARKANSAS
35F726MEDICARE PINARKANSAS

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: 3/30/2025

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