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FAMILY MEDICINE ASSOCIATES OF PINE NPI 1831130616


NPI Information

NPI: 1831130616
Provider Name: FAMILY MEDICINE ASSOCIATES OF PINE
Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

CLIA Number: 04D0695237

Address:
1801 W 40TH AVE
SUITE 6A
PINE BLUFF, AR
ZIP 71603
Phone: (870) 541-9373
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FAMILY MEDICINE ASSOCIATES OF PINE is a primary care clinic center in Pine Bluff, AR. FAMILY MEDICINE ASSOCIATES OF PINE NPI is 1831130616. The provider is registered as an organization entity type.

The provider's business location address is:

1801 W 40TH AVE
SUITE 6A
PINE BLUFF, AR
ZIP 71603-900
Phone: (870) 541-9373
Fax: (870) 541-0109

The provider's authorized official is Mary E Frazier .
The authorized official title is Manager and has the following contact phone number (870) 541-9373.

The CLIA number assigned to this NPI record is 04D0695237 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/10/2006 and was last updated on 12/8/2010.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1261QP2300XClinic/CenterPrimary CareYes

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
157007MEDICARE 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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