Provider Demographics
NPI:1932949385
Name:PWCLR, P.A.
Entity type:Organization
Organization Name:PWCLR, P.A.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BILLING DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:COONFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:479-365-0001
Mailing Address - Street 1:PO BOX 241247
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72223-0005
Mailing Address - Country:US
Mailing Address - Phone:501-359-6655
Mailing Address - Fax:501-359-6650
Practice Address - Street 1:1225 BRECKENRIDGE DR STE 110
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-1565
Practice Address - Country:US
Practice Address - Phone:501-359-6655
Practice Address - Fax:501-359-6650
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-31
Last Update Date:2024-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty