Organization
HARRISON PEDIATRICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SOMA GHOSH (OFFICE MANAGER)
(870) 391-5903
Entity
Organization
Contact information
Practice address
1418 MCCOY DR, HARRISON, AR 72601-2411
(870) 391-5903
(870) 743-4641
Mailing address
1418 MCCOY DR, HARRISON, AR 72601-2411
(870) 391-5903
(870) 743-4641
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
MC-3097
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
210549002
—
AR
Enumeration date
12/22/2015
Last updated
12/22/2015
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