| Suphan Medical Clinic | |
|
11811 Hinson Rd Ste 200 Little Rock AR 72212-3404 | |
| (501) 225-7500 | |
| (501) 225-7510 |
| Full Name | Suphan Medical Clinic |
|---|---|
| Speciality | Family Medicine |
| Location | 11811 Hinson Rd Ste 200, Little Rock, Arkansas |
| Authorized Official Name and Position | Neema G. Suphan (PHYSICIAN) |
| Authorized Official Contact | 5012257500 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Suphan Medical Clinic 11811 Hinson Rd Ste 200 Little Rock AR 72212-3404 Ph: (501) 225-7500 | Suphan Medical Clinic 11811 Hinson Rd Ste 200 Little Rock AR 72212-3404 Ph: (501) 225-7500 |
| NPI Number | 1679764419 |
|---|---|
| Provider Enumeration Date | 08/07/2007 |
| Last Update Date | 08/07/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679764419 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | R-2871 (Arkansas) | Primary |
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