Organization
NORTH LITTLE ROCK PRIMARY CARE AND DIAGNOSTIC CLINIC PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DEREK LEWIS MD (PRESIDENT)
(501) 771-7717
Entity
Organization
Contact information
Practice address
400 W PERSHING BLVD, N LITTLE ROCK, AR 72114-2146
(501) 771-7717
(501) 771-0550
Mailing address
400 W PERSHING BLVD, N LITTLE ROCK, AR 72114-2146
(501) 771-7717
(501) 771-0550
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
133705002
—
AR
01
—
5B979
BLUE CROSS
AR
Enumeration date
07/06/2006
Last updated
01/03/2017
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