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NPI Code Detail

MEDICARE: EASY ACCESS HEALTHCARE MEDICAL CLINIC

MEDICARE: EASY ACCESS HEALTHCARE MEDICAL CLINIC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QU0200XUrgent Care Clinic/CenterATP-000264AR

General Provider Information

NPI Number : 1063736791
Entity Type Code : Organization
Provider Name (Legal Business Name) : EASY ACCESS HEALTHCARE MEDICAL CLINIC
Provider Business Mailing Address
First Line : 105 N RODNEY PARHAM RD
Second Line :
City : LITTLE ROCK
State : AR
Zip : 72205-2421
Country : US
Telephone Number : 501-221-1831
Fax Number :
Provider Business Practice Location Address
First Line : 105 N RODNEY PARHAM RD
Second Line :
City : LITTLE ROCK
State : AR
Zip : 72205-2421
Country : US
Telephone Number : 501-221-1831
Fax Number :
Authorized Official
Title or Position : APN-FAMILY PRACTITIONER
Name : WANNETTA CLOWERS
Credential :
Telephone Number : 870-536-3279
Provider Enumeration Date : 03/24/2010
Last Update Date : 03/24/2010

Similar Medicare Providers

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Practice Location Address:
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1932116167 — WILLIAM F GIBSON D.D.S., P.A.
Practice Location Address:
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1891077236 — PAUL BURTON, DDS, PA
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Directions to “EASY ACCESS HEALTHCARE MEDICAL CLINIC ” Practice Location

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