Organization
SPINE CARE OF ARKANSAS P.L.L.C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CHRISTY CLAY (INSURACE REP)
(501) 975-5005
Entity
Organization
Contact information
Practice address
14918 CANTRELL RD, LITTLE ROCK, AR 72223-4248
(501) 975-5005
(501) 975-5008
Mailing address
PO BOX 34113, LITTLE ROCK, AR 72203-4113
(501) 975-5005
(501) 975-5008
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
E2047
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
136646001
—
AR
01
—
5C982
MCR & BCBS PAYOR #
AR
Enumeration date
07/05/2007
Last updated
07/02/2010
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