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General NPI Number Information
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NPI Number | 1699096297
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Entity Type | Organization
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Legal Business Name | WALK IN CENTER
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Dates
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Enumeration Date | 06/17/2010
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Last Update Date | 06/10/2022
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Provider Practice Location Address
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Address Line | 1102 CRESTWOOD CIR
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City | MENA
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State | AR
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Zip | 71953-5513
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Country | US
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Telephone | 479-394-7301
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Fax | 479-394-7160
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Provider Business Mailing Address
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Address Line | PO BOX 1325
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City | MENA
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State | AR
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Zip | 71953-1325
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Country | US
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Telephone | 479-394-1414
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Fax | 870-289-6993
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Authorized Official
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Title or Position | CEO
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Name | ROBERT RUPP
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Credential |
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Telephone | 479-394-6100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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