Great River Pediatric Clinic

LBN: Great River Pediatric Clinic
Great River Pediatric Clinic is an health care organization with primary practice located at 1521 N 10Th St Ste F, Blytheville AR 72315-1405. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as the primary health care specialty. Great River Pediatric Clinic can be contacted via phone (870) 780-6832, or through Asafo-Boakye, Benjamin via phone (870) 780-6832.

Contact Information

Primary practice address
1521 N 10Th St Ste F Blytheville AR 72315-1405
Phone: (870) 780-6832
Fax: (870) 780-6919
Website:
Map and Directions
Authorized official contact:
Name: Asafo-Boakye, Benjamin M.D., MPH, FAAP
Phone: (870) 780-6832

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X E-4133 Arkansas

Profile Details

NPI number 1467586131
LBN Legal business name Great River Pediatric Clinic
DBA Doing business as
Authorized official Asafo-Boakye, Benjamin M.D., MPH, FAAP
Entity Organization
Organization subpart 1 No
Enumeration date Mar 15th, 2007
Last updated Aug 22nd, 2020 - about 6 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1467586131 NPPES
Arkansas Other 5F511 BLUE CROSS BLUE SHIELD

Popular Providers