Fair Park Medical Clinic

NPI 1740481191 - Internal Medicine - 207R00000X

NPI Details
NPI 1740481191
Enumeration Date 05/31/2007
Last Updated 07/08/2007
Entity Type Healthcare Provider
Active Over 9 years ago
Authorized Information
Name CARL LYNN CARL
Position OWNER
Phone (501) 663-6262
Fax (501) 663-3189
Practice Location
5320 W 12TH ST
LITTLE ROCK AR, 72204-1859, US
Phone (501) 663-6262
Fax (501) 663-3189
Business Location
5320 W. 12TH STREET
LITTLE ROCK AR, 72206, US
Phone (501) 663-6262
Fax (501) 663-3189
Toxanomy
Taxonomy Code 207R00000X
License State Arkansas
License Number MC2208
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According to our database, Fair Park Medical Clinic NPI is 1740481191, taxonomy code is 207R00000X and license number is MC2208, license state is located at Arkansas. Fair Park Medical Clinic physically located at 5320 W 12th St, Little Rock AR, 72204-1859. NPI Number 1033115704 has the healthcare provider type.

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1740481191 NPI number is provided on an as is basis without warranty of any kind. 1740481191 is maintained by the National Plan & Provider Enumeration System. The contents of Fair Park Medical Clinic are for informational purposes only.