Great River Pediatric Clinic

NPI 1467586131 - Pediatrics - 208000000X

NPI Details
NPI 1467586131
Enumeration Date 03/15/2007
Last Updated 07/08/2007
Entity Type Healthcare Provider
Active Over 9 years ago
Authorized Information
Name BENJAMIN BENJAMIN
Position PEDIATRICIAN
Phone (870) 780-6832
Fax (870) 780-6919
Practice Location
1521 N 10TH ST
STE F
BLYTHEVILLE AR, 72315-1405, US
Phone (870) 780-6832
Fax (870) 780-6919
Business Location
1521 N 10TH ST
STE F
BLYTHEVILLE AR, 72315-1405, US
Phone (870) 780-6832
Fax (870) 780-6919
Toxanomy
Taxonomy Code 208000000X
License State Arkansas
License Number E-4133
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According to our database, Great River Pediatric Clinic NPI is 1467586131, taxonomy code is 208000000X and license number is E-4133, license state is located at Arkansas. Great River Pediatric Clinic physically located at 1521 N 10th St, Blytheville AR, 72315-1405. NPI Number 1033115704 has the healthcare provider type.

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1467586131 NPI number is provided on an as is basis without warranty of any kind. 1467586131 is maintained by the National Plan & Provider Enumeration System. The contents of Great River Pediatric Clinic are for informational purposes only.