Organization
TLC PEDIATRICS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TERENCE L CHAMPLIN M.D. (OWNER)
(501) 327-2444
Entity
Organization
Contact information
Practice address
955 CAROLYN LN, CONWAY, AR 72034-5015
(501) 327-2444
(501) 327-2443
Mailing address
955 CAROLYN LN, CONWAY, AR 72034-5015
(501) 327-2444
(501) 327-2443
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MC-2758
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
183907002
—
AR
01
—
5G341
BCBS
AR
Enumeration date
07/28/2010
Last updated
01/28/2020
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