Organization
CHILDREN'S CLINIC, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HORACE L GREEN M.D. (PHYSICIAN)
(870) 534-6210
Entity
Organization
Contact information
Practice address
1420 W 43RD AVE, PINE BLUFF, AR 71603-7010
(870) 534-6210
(870) 534-8620
Mailing address
1420 W 43RD AVE, PINE BLUFF, AR 71603-7010
(870) 534-6210
(870) 534-8620
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
56703
ARKANSAS BLUE CROSS
—
Enumeration date
04/12/2006
Last updated
08/22/2020
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