Organization
DERMLOGIC, P.L.L.C, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KIM M HIATT M.D. (MANAGER)
(501) 551-6408
Entity
Organization
Contact information
Practice address
9780 MAUMELLE BLVD, NORTH LITTLE ROCK, AR 72113-6737
(501) 753-9000
(501) 753-9004
Mailing address
9780 MAUMELLE BLVD, NORTH LITTLE ROCK, AR 72113-6737
(501) 753-9000
(501) 753-9004
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
E3291
AR
Other
Enumeration date
06/07/2012
Last updated
06/07/2012
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