# LITTLE ROCK ALLERGY & ASTHMA CLINIC PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1154360576
- **Authorized official:** JENNIFER WAKE (OPERATIONS MANAGER)
- **Authorized official phone:** (501) 978-7113

## Contact information

- **Practice address:** 18 CORPORATE HILL DR, SUITE 110, LITTLE ROCK, AR 72205-4565
- **Practice address phone:** (501) 224-1156
- **Practice address fax:** (501) 801-5561
- **Mailing address:** 18 CORPORATE HILL DRIVE, SUITE 110, LITTLE ROCK, AR 72205-4565

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207K00000X | Allergy & Immunology Physician | MC0750 | AR | Yes |

## Other

- **Enumeration date:** 06/05/2006
- **Last updated:** 10/16/2014