Provider Demographics
NPI:1124057088
Name:CENTRAL ARKANSAS PEDIATRIC CLINIC
Entity type:Organization
Organization Name:CENTRAL ARKANSAS PEDIATRIC CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:
Authorized Official - Last Name:ARNOLD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:501-847-2500
Mailing Address - Street 1:2301 SPRINGHILL RD STE 200
Mailing Address - Street 2:
Mailing Address - City:BENTON
Mailing Address - State:AR
Mailing Address - Zip Code:72015-7552
Mailing Address - Country:US
Mailing Address - Phone:501-847-2500
Mailing Address - Fax:501-943-3016
Practice Address - Street 1:2301 SPRINGHILL RD STE 200
Practice Address - Street 2:
Practice Address - City:BENTON
Practice Address - State:AR
Practice Address - Zip Code:72015-7552
Practice Address - Country:US
Practice Address - Phone:501-847-2500
Practice Address - Fax:501-943-3016
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes173000000XOther Service ProvidersLegal MedicineGroup - Single Specialty