Provider Demographics
NPI:1487888236
Name:CENTRAL ARKANSAS CLINIC, PLLC
Entity type:Organization
Organization Name:CENTRAL ARKANSAS CLINIC, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:B
Authorized Official - Last Name:REICHARD
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:501-372-7246
Mailing Address - Street 1:PO BOX 7838
Mailing Address - Street 2:
Mailing Address - City:TEXARKANA
Mailing Address - State:TX
Mailing Address - Zip Code:75505-7838
Mailing Address - Country:US
Mailing Address - Phone:501-372-7246
Mailing Address - Fax:501-324-1518
Practice Address - Street 1:500 S UNIVERSITY AVE STE 305
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-5342
Practice Address - Country:US
Practice Address - Phone:501-372-7246
Practice Address - Fax:501-324-1518
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-08
Last Update Date:2009-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Single Specialty