MEDICARE: LITTLE ROCK ALLERGY & ASTHMA CLINIC PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207K00000X	Allergy & Immunology Physician	MC0750	AR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1154360576
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LITTLE ROCK ALLERGY & ASTHMA CLINIC PA

Provider Business Mailing Address
First Line	:	18 CORPORATE HILL DRIVE
Second Line	:	SUITE 110
City	:	LITTLE ROCK
State	:	AR
Zip	:	72205-4565
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	18 CORPORATE HILL DR
Second Line	:	SUITE 110
City	:	LITTLE ROCK
State	:	AR
Zip	:	72205-4565
Country	:	US
Telephone Number	:	501-224-1156
Fax Number	:	501-801-5561

Authorized Official
Title or Position	:	OPERATIONS MANAGER
Name	:	JENNIFER WAKE
Credential	:
Telephone Number	:	501-978-7113

Provider Enumeration Date	:	06/05/2006
Last Update Date	:	10/16/2014

Similar Medicare Providers

1023940418 — TULSHI AMIN DNP
Practice Location Address:

18 CORPORATE HILL DR STE 110
LITTLE ROCK, AR
72205-4565

Practice Phone: 501-224-1156
Practice Fax:

1518959691 — DR. KARL VANCE SITZ M.D.
Practice Location Address:

18 CORPORATE HILL DRIVE , SUITE 110
LITTLE ROCK, AR
72205-4565

Practice Phone: 501-224-1156
Practice Fax: 501-801-5561

1871585950 — DR. BLAKE GRAHAM SCHEER M.D.
Practice Location Address:

18 CORPORATE HILL DRIVE , SUITE 110
LITTLE ROCK, AR
72205-4565

Practice Phone: 501-224-1156
Practice Fax: 501-801-5561

1093707176 — DR. JIM MARK INGRAM M.D.
Practice Location Address:

18 CORPORATE HILL DR , SUITE 110
LITTLE ROCK, AR
72205-4565

Practice Phone: 501-224-1156
Practice Fax: 501-801-5561

1407892805 — STACY SIRMAR GRIFFIN M.D.
Practice Location Address:

18 CORPORATE HILL DR STE 110
LITTLE ROCK, AR
72205-4565

Practice Phone: 501-224-1156
Practice Fax: 501-223-2625

1902292329 — KIM NGAN THI JACKSON MD
Practice Location Address:

18 CORPORATE HILL DR STE 110
LITTLE ROCK, AR
72205-4565

Practice Phone: 501-224-1156
Practice Fax: 501-223-2625

Directions to “LITTLE ROCK ALLERGY & ASTHMA CLINIC PA ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.