| Cavs | |
|
11c/nlr Towbin Health Care 2200 Fort Roots Drive North Little Rock AR 72114 | |
| (501) 257-2627 | |
| Not Available |
| Full Name | Cavs |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 11c/nlr Towbin Health Care 2200 Fort Roots Drive, North Little Rock, Arkansas |
| Authorized Official Name and Position | Terence Benjamin Wilson (STAFF PHYSICIAN) |
| Authorized Official Contact | 5012572627 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Cavs 11c/nlr Towbin Health Care 2200 Fort Roots Drive North Little Rock AR 72114 Ph: (501) 257-2627 | Cavs 11c/nlr Towbin Health Care 2200 Fort Roots Drive North Little Rock AR 72114 Ph: (501) 257-2627 |
| NPI Number | 1063514388 |
|---|---|
| Provider Enumeration Date | 09/05/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063514388 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | C4907 (Arkansas) | Primary |
Kelli Keene Sanders, Md Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 505 W Pershing Blvd Ste B, North Little Rock, AR 72114 Phone: 501-753-1881 Fax: 501-753-2133 | |
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