| NPI | 1912912361 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFF CLIFTON COO 479-273-3376 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: AR E3363) |
| Additional Taxonomies | 207NI0002X Dermatology, Clinical & Laboratory Dermatological Immunology (Licence: AR 04D1034086) |
| 207NP0225X Dermatology, Pediatric Dermatology (Licence: AR E3363) | |
| 207NS0135X Dermatology, Procedural Dermatology (Licence: AR E3363) | |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2020-08-22 |