Healthcare Provider Details

I. General information

NPI: 1699096297
Provider Name (Legal Business Name): WALK IN CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/17/2010
Last Update Date: 06/10/2022
Certification Date: 06/01/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1102 CRESTWOOD CIR
MENA AR
71953-5513
US

IV. Provider business mailing address

PO BOX 1325
MENA AR
71953-1325
US

V. Phone/Fax

Practice location:
  • Phone: 479-394-7301
  • Fax: 479-394-7160
Mailing address:
  • Phone: 479-394-1414
  • Fax: 870-289-6993

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: ROBERT RUPP
Title or Position: CEO
Credential:
Phone: 479-394-6100