Organization
HEART CLINIC ARKANSAS
Active
Organization
HEART CLINIC ARKANSAS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RANDY A JORDAN M.D. (PRESIDENT)
(501) 255-6000
Entity
Organization
Contact information
Practice address
10100 KANIS RD, LITTLE ROCK, AR 72205-6202
(501) 255-6000
(501) 255-6400
Mailing address
10100 KANIS RD, LITTLE ROCK, AR 72205-6202
(501) 255-6000
(501) 255-6400
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04D0978456
CLIA NUMBER-KANIS
AR
05
—
136666002
—
AR
Enumeration date
05/26/2006
Last updated
01/21/2011
Update your record
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