Healthcare Provider Details

I. General information

NPI: 1326862962
Provider Name (Legal Business Name): LITTLE ROCK WALK IN CLINIC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/11/2024
Last Update Date: 02/13/2025
Certification Date: 02/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

802 N UNIVERSITY AVE
LITTLE ROCK AR
72205-2920
US

IV. Provider business mailing address

5700 W MARKHAM ST
LITTLE ROCK AR
72205-3328
US

V. Phone/Fax

Practice location:
  • Phone: 501-291-2322
  • Fax: 888-388-5166
Mailing address:
  • Phone: 501-227-0184
  • Fax: 501-227-0187

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: DR. AMIR M QURESHI
Title or Position: MD
Credential: MD
Phone: 501-940-6951