Provider Demographics
NPI:1043327950
Name:NORTH HILLS FAMILY CLINIC PA
Entity type:Organization
Organization Name:NORTH HILLS FAMILY CLINIC PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:PENNIE
Authorized Official - Middle Name:M
Authorized Official - Last Name:BIGGERSTAFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:501-945-4200
Mailing Address - Street 1:4509 E MCCAIN BLVD
Mailing Address - Street 2:
Mailing Address - City:NORTH LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72117-2902
Mailing Address - Country:US
Mailing Address - Phone:501-945-4200
Mailing Address - Fax:501-945-0906
Practice Address - Street 1:4509 E MCCAIN BLVD
Practice Address - Street 2:
Practice Address - City:NORTH LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72117-2902
Practice Address - Country:US
Practice Address - Phone:501-945-4200
Practice Address - Fax:501-945-0906
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-24
Last Update Date:2015-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty