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General NPI Number Information
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NPI Number | 1396897260
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Entity Type | Organization
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Legal Business Name | LITTLE ROCK FERTILITY CENTER
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Dates
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Enumeration Date | 01/18/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 9101 KANIS RD SUITE 300
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City | LITTLE ROCK
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State | AR
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Zip | 72205-6417
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Country | US
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Telephone | 501-801-1200
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Fax | 501-801-1207
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Provider Business Mailing Address
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Address Line | 9101 KANIS RD SUITE 300
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City | LITTLE ROCK
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State | AR
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Zip | 72205-6417
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Country | US
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Telephone | 501-801-1200
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Fax | 501-801-1207
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Authorized Official
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Title or Position | CLINICAL ADMINISTRATOR
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Name | MS. SARAH L HUMPHRIESH
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Credential | MNSC
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Telephone | 501-801-1200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number | AR4372
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License Number State | AR
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