Healthcare Provider Details

I. General information

NPI: 1487601555
Provider Name (Legal Business Name): NORTH LITTLE ROCK WOMEN'S CLINIC, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/27/2006
Last Update Date: 08/01/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3401 SPRINGHILL DR SUITE 390
NORTH LITTLE ROCK AR
72117-2924
US

IV. Provider business mailing address

3401 SPRINGHILL DR SUITE 390
NORTH LITTLE ROCK AR
72117-2924
US

V. Phone/Fax

Practice location:
  • Phone: 501-835-9444
  • Fax: 501-835-9731
Mailing address:
  • Phone: 501-835-9444
  • Fax: 501-835-9731

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License NumberC5070
License Number StateAR
# 2
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License NumberE2317
License Number StateAR
# 3
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License NumberE4442
License Number StateAR
# 4
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberC4934
License Number StateAR

VIII. Authorized Official

Name: MS. JUDY LAMAN
Title or Position: ADMINISTRATOR
Credential:
Phone: 501-835-9444