| Infinite Genomics | |
|
4850 Northshore Ln North Little Rock AR 72118-5329 | |
| (501) 798-7100 | |
| Not Available |
| Full Name | Infinite Genomics |
|---|---|
| Speciality | Internal Medicine |
| Location | 4850 Northshore Ln, North Little Rock, Arkansas |
| Authorized Official Name and Position | Hilda Dupwe (AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 5017987100 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Infinite Genomics 4850 Northshore Ln North Little Rock AR 72118-5329 | Infinite Genomics 4850 Northshore Ln North Little Rock AR 72118-5329 Ph: (501) 798-7100 |
| NPI Number | 1740179282 |
|---|---|
| Provider Enumeration Date | 06/30/2025 |
| Last Update Date | 06/30/2025 |
| Certification Date | 06/30/2025 |
| Medicare PECOS PAC ID | 7719377712 |
|---|---|
| Medicare Enrollment ID | O20250724000525 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740179282 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | () | Primary |
| 207ZP0105X | Pathology - Clinical Pathology/laboratory Medicine | () | Secondary |
| Provider Name | Brent Christopher Staggs |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1164508883 PECOS PAC ID: 6507838158 Enrollment ID: I20040831001134 |
| Provider Name | Theodore S Chang |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1154617843 PECOS PAC ID: 1254623861 Enrollment ID: I20160629002914 |
| Provider Name | Nancy Davis |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1770621658 PECOS PAC ID: 7810091733 Enrollment ID: I20170330002198 |
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