| Little Rock Diagnostic Clinic Asc | |
|
10001 Lile Dr Little Rock AR 72205-6217 | |
| (501) 227-8000 | |
| (501) 221-5895 |
| Full Name | Little Rock Diagnostic Clinic Asc |
|---|---|
| Speciality | Clinic/center - Ambulatory Surgical |
| Location | 10001 Lile Dr, Little Rock, Arkansas |
| Authorized Official Name and Position | Darlene Carol Hebda (CREDENTIALING COORDINATOR) |
| Authorized Official Contact | 5012234543 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Little Rock Diagnostic Clinic Asc 10001 Lile Dr Little Rock AR 72205-6217 Ph: (501) 227-8000 | Little Rock Diagnostic Clinic Asc 10001 Lile Dr Little Rock AR 72205-6217 Ph: (501) 227-8000 |
| NPI Number | 1760418891 |
|---|---|
| Provider Enumeration Date | 06/23/2006 |
| Last Update Date | 03/07/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760418891 | NPI | - | NPPES |
| 122223128 | Medicaid | AR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
| 261QA1903X | Clinic/center - Ambulatory Surgical | (Arkansas) | Primary |
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