| Hillcrest Clinic, Inc. | |
|
3000 Kavanaugh Blvd Ste 209a Little Rock AR 72205-3769 | |
| (501) 680-4239 | |
| Not Available |
| Full Name | Hillcrest Clinic, Inc. |
|---|---|
| Speciality | Social Worker |
| Location | 3000 Kavanaugh Blvd Ste 209a, Little Rock, Arkansas |
| Authorized Official Name and Position | Eric I Phelps (PRESIDENT) |
| Authorized Official Contact | 5016804239 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Hillcrest Clinic, Inc. 1922 Pine Valley Rd Little Rock AR 72207-1817 Ph: (501) 680-4239 | Hillcrest Clinic, Inc. 3000 Kavanaugh Blvd Ste 209a Little Rock AR 72205-3769 Ph: (501) 680-4239 |
| NPI Number | 1427481282 |
|---|---|
| Provider Enumeration Date | 08/15/2013 |
| Last Update Date | 08/15/2013 |
| Medicare PECOS PAC ID | 7911140694 |
|---|---|
| Medicare Enrollment ID | O20130828000198 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427481282 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 2293-C (Arkansas) | Primary |
| Provider Name | Eric I Phelps |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1679609937 PECOS PAC ID: 8820231509 Enrollment ID: I20130924000563 |
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