NPI 1255395950 · live from the CMS NPI Registry
Children'S Clinic, P.A.
Pediatrics, Adolescent Medicine in Pine Bluff, AR. National Provider Identifier 1255395950, active.
NPI record
| NPI | 1255395950 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Pediatrics, Adolescent Medicine 2080A0000X |
| Practice location | 1420 W 43rd Ave, Pine Bluff, AR 71603 |
| Practice phone | 870-534-6210 |
| Enumerated | April 12, 2006 |
| Last updated | August 22, 2020 |
| Authorized official | Horace Green, Physician |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Pediatrics, Adolescent Medicine primary | 2080A0000X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.