Organization
ARKANSAS INTERNAL MEDICINE CLINIC PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SOLOMON CHUKWUEMEKA MOGBO M.D (PRESIDENT)
(501) 537-4590
Entity
Organization
Contact information
Practice address
500 S UNIVERSITY AVE STE 605, LITTLE ROCK, AR 72205-5308
(501) 537-4590
Mailing address
500 S UNIVERSITY AVE STE 605, LITTLE ROCK, AR 72205-5308
(501) 537-4590
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
EI875
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
145707001
—
AR
05
—
149931002
—
AR
Enumeration date
03/27/2007
Last updated
11/09/2009
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