Organization
LITTLE ROCK DIAGNOSTIC CLINIC PA
Active
Other names
Little Rock Diagnostic Clinic ASC
Organization subpart
No
Provider details
NPI number
Authorized official
DARLENE CAROL HEBDA (CREDENTIALING COORDINATOR)
(501) 223-4543
Entity
Organization
Contact information
Practice address
10001 LILE DR, LITTLE ROCK, AR 72205-6217
(501) 227-8000
(501) 221-5895
Mailing address
10001 LILE DR, LITTLE ROCK, AR 72205-6217
(501) 227-8000
(501) 221-5895
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
—
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
122223128
—
AR
Enumeration date
06/23/2006
Last updated
03/07/2018
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