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Organization

ARKANSAS DIAGNOSTIC CENTER, PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. MARION YORK (OFFICE ADMINISTRATOR)
(501) 227-7688
Entity
Organization

Contact information

Practice address
8908 KANIS RD, LITTLE ROCK, AR 72205-6414
(501) 227-7688
(501) 228-3509
Mailing address
PO BOX 55130, LITTLE ROCK, AR 72215-5130
(501) 227-7688
(501) 228-3509

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
BL109593
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
196121716
MEDICAID DME/PROSTHETICS
AR
Enumeration date
04/16/2013
Last updated
04/16/2013
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