Organization
PREMIER PEDIATRICS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. STACI POLLARD (OFFICE MANAGER)
(479) 763-3050
Entity
Organization
Contact information
Practice address
5901 RILEY PARK DRIVE, SUITE B, FORT SMITH, AR 72916
(479) 763-3050
(479) 763-3281
Mailing address
5901 RILEY PARK DRIVE, SUITE B, FORT SMITH, AR 72916-9340
(479) 763-3050
(479) 763-3281
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
E-6232
ARKANSAS MEDICAL LICENSE
AR
Enumeration date
02/21/2019
Last updated
07/02/2019
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