Otter Creek Family Clinic Pllc

LBN: Otter Creek Family Clinic Pllc
Otter Creek Family Clinic Pllc is an health care organization with primary practice located at 11321 Interstate 30 Ste 101, Little Rock AR 72209-7059. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as the primary health care specialty. Otter Creek Family Clinic Pllc can be contacted via phone (501) 455-1331, or through Alexander, Rita A via phone (501) 455-1331.

Contact Information

Primary practice address
11321 Interstate 30 Ste 101 Little Rock AR 72209-7059
Phone: (501) 455-1331
Fax: (501) 455-5597
Website:
Map and Directions
Authorized official contact:
Name: Alexander, Rita A
Phone: (501) 455-1331

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X C5502 Arkansas

Profile Details

NPI number 1336122340
LBN Legal business name Otter Creek Family Clinic Pllc
DBA Doing business as
Authorized official Alexander, Rita A
Entity Organization
Organization subpart 1 No
Enumeration date Nov 23rd, 2005
Last updated Jun 23rd, 2010 - about 14 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1336122340 NPPES
Arkansas MEDICAID 140671002
Arkansas Other CG8625

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