Organization
THE PEDIATRIC CLINIC OF NLR, P.A.
Active
Parent organization
THE PEDIATRIC CLINIC OF NLR, P.A.
Other names
The Pediatric Clinic
Organization subpart
Yes
Provider details
NPI number
Legal business name
THE PEDIATRIC CLINIC OF NLR, P.A.
Authorized official
TONYA SIMS RN (ADMINISTRATOR)
(501) 758-1530
Entity
Organization
Contact information
Practice address
203B PLAZA BLVD, CABOT, AR 72023-3749
(501) 843-0068
(501) 843-0696
Mailing address
1525 COUNTRY CLUB RD, SHERWOOD, AR 72120-5076
(501) 758-1530
(501) 819-6171
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
180601002
—
AR
Enumeration date
08/05/2021
Last updated
08/05/2021
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