Organization
LITTLE ROCK PEDIATRIC GROUP
Active
Other names
Little Rock Pediatric Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
JO LYNNE VARNER MHSA (ADMINISTRATOR)
(501) 664-4044
Entity
Organization
Contact information
Practice address
500 S UNIVERSITY AVE STE 615, LITTLE ROCK, AR 72205-5308
(501) 664-4044
(501) 664-4064
Mailing address
500 S UNIVERSITY AVE STE 615, LITTLE ROCK, AR 72205-5308
(501) 664-4044
(501) 664-4064
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
145428002
—
AR
Enumeration date
06/19/2006
Last updated
07/05/2022
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