| Sma Medicine & Nephrology Clinic Llc | |
|
1515 Kanis Park Dr Ste B Little Rock AR 72205-4569 | |
| (501) 603-9277 | |
| (501) 603-9877 |
| Full Name | Sma Medicine & Nephrology Clinic Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1515 Kanis Park Dr Ste B, Little Rock, Arkansas |
| Authorized Official Name and Position | Moses C Ejiofor (PRESIDENT) |
| Authorized Official Contact | 5016039277 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sma Medicine & Nephrology Clinic Llc 1515 Kanis Park Dr Ste B Little Rock AR 72205-4569 Ph: (501) 603-9277 | Sma Medicine & Nephrology Clinic Llc 1515 Kanis Park Dr Ste B Little Rock AR 72205-4569 Ph: (501) 603-9277 |
| NPI Number | 1437209491 |
|---|---|
| Provider Enumeration Date | 01/11/2007 |
| Last Update Date | 11/30/2017 |
| Medicare PECOS PAC ID | 1951438886 |
|---|---|
| Medicare Enrollment ID | O20100423000410 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437209491 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (Arkansas) | Primary |
| Provider Name | Moses C Ejiofor |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1942277843 PECOS PAC ID: 1557396579 Enrollment ID: I20050928001139 |
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