College Park Family Clinic Pa
LBN: College Park Family Clinic Pa
College Park Family Clinic Pa is an health care organization with primary practice located at 2511-A College Ave , Conway AR 72034. The organization recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medicine, Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Pediatrics. Allopathic & Osteopathic Physicians / Emergency Medicine is the primary health care specialty.
College Park Family Clinic Pa can be contacted via phone (501) 327-6041, or through Johnson, Gil E via phone (501) 327-6041.
Contact Information
Primary practice address
2511-A College Ave
Conway AR 72034
Phone: (501) 327-6041
Fax: (501) 327-6043
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Emergency Medicine | 207P00000X | C6340 | Arkansas |
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | C6340 | Arkansas |
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | C6340 | Arkansas |
Profile Details
| NPI number | 1861478232 |
|---|---|
| LBN Legal business name | College Park Family Clinic Pa |
| DBA Doing business as | |
| Authorized official | Johnson, Gil E Doctor of Medicine (MD) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Dec 19th, 2005 |
| Last updated | Aug 22nd, 2020 - about 4 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1861478232 | NPPES |
| Arkansas | Other | 11451000000 | QC |
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