| Nayles Medical Clinic, Llc | |
|
1400 Main St Little Rock AR 72202-5036 | |
| (501) 371-0055 | |
| (501) 371-0088 |
| Full Name | Nayles Medical Clinic, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 1400 Main St, Little Rock, Arkansas |
| Authorized Official Name and Position | Lana Nayles (OFFICE ADMINISTRATOR) |
| Authorized Official Contact | 5013710055 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Nayles Medical Clinic, Llc 1400 Main St Little Rock AR 72202-5036 Ph: (501) 371-0055 | Nayles Medical Clinic, Llc 1400 Main St Little Rock AR 72202-5036 Ph: (501) 371-0055 |
| NPI Number | 1265591267 |
|---|---|
| Provider Enumeration Date | 12/06/2006 |
| Last Update Date | 11/07/2016 |
| Medicare PECOS PAC ID | 4789817321 |
|---|---|
| Medicare Enrollment ID | O20140506000123 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265591267 | NPI | - | NPPES |
| 103668001 | Medicaid | AR | |
| 5F409 | Other | AR | GROUP P TAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | C6342 (Arkansas) | Primary |
| Provider Name | Lee C Nayles |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1164482592 PECOS PAC ID: 1850340332 Enrollment ID: I20050121000794 |
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