Healthcare Provider Details
I. General information
NPI: 1740179282
Provider Name (Legal Business Name): INFINITE GENOMICS
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/30/2025
Last Update Date: 06/30/2025
Certification Date: 06/30/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4850 NORTHSHORE LN
NORTH LITTLE ROCK AR
72118-5329
US
IV. Provider business mailing address
4850 NORTHSHORE LN
NORTH LITTLE ROCK AR
72118-5329
US
V. Phone/Fax
- Phone: 501-798-7100
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207ZP0105X |
| Taxonomy | Clinical Pathology/Laboratory Medicine Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
HILDA
DUPWE
Title or Position: AUTHORIZED OFFICIAL
Credential:
Phone: 501-798-7100