NPI | 1740481191 |
---|---|
Doing Business As | FAIR PARK MEDICAL CLINIC |
Entity Type | Organization |
Authorized Contact | CARL LYNN JOHNSON Owner 501-663-6262 |
Organization Subpart ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: AR MC2208) |
Enumeration Date | 2007-05-31 |
Last Update Date | 2020-08-22 |