| Cardiology And Medicine Clinic P A | |
|
5315 W 12th St Little Rock AR 72204-1858 | |
| (501) 664-0941 | |
| (501) 666-3956 |
| Full Name | Cardiology And Medicine Clinic P A |
|---|---|
| Speciality | Internal Medicine - Cardiovascular Disease |
| Location | 5315 W 12th St, Little Rock, Arkansas |
| Authorized Official Name and Position | Alicia Ferguson Smith (CLINIC ADMINISTRATOR) |
| Authorized Official Contact | 5016640941 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Cardiology And Medicine Clinic P A 5315 W 12th St Little Rock AR 72204-1858 Ph: (501) 664-0941 | Cardiology And Medicine Clinic P A 5315 W 12th St Little Rock AR 72204-1858 Ph: (501) 664-0941 |
| NPI Number | 1679567408 |
|---|---|
| Provider Enumeration Date | 09/08/2005 |
| Last Update Date | 07/18/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679567408 | NPI | - | NPPES |
| 145330002 | Medicaid | AR | |
| D9086 | Other | RAILROAD MEDICARE | |
| 5B371 | Other | AR | BLUE CROSS/BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
| 207RC0000X | Internal Medicine - Cardiovascular Disease | (* (Not Available)) | Primary |
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