Organization
FAIR PARK MEDICAL CLINIC
Active
Other names
Fair Park Medical Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CARL LYNN JOHNSON M.D. (OWNER)
(501) 663-6262
Entity
Organization
Contact information
Practice address
5320 W 12TH ST, LITTLE ROCK, AR 72204-1859
(501) 663-6262
(501) 663-3189
Mailing address
5320 W. 12TH STREET, LITTLE ROCK, AR 72206
(501) 663-6262
(501) 663-3189
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MC2208
AR
Other
Enumeration date
05/31/2007
Last updated
08/22/2020
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