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EASTSIDE OB/GYN P.L.L.C. NPI 1396786042


NPI Information

NPI: 1396786042
Provider Name: EASTSIDE OB/GYN P.L.L.C.
Classification: Obstetrics & Gynecology - 207V00000X
Entity Type: Organization

CLIA Number: 04D0701088

Address:
7001 ROGERS AVE
SUITE 502
FORT SMITH, AR
ZIP 72903
Phone: (479) 484-5901
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EASTSIDE OB/GYN P.L.L.C. is an obstetrics gynecology in Fort Smith, AR. The provider is an obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. EASTSIDE OB/GYN P.L.L.C. NPI is 1396786042. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

7001 ROGERS AVE
SUITE 502
FORT SMITH, AR
ZIP 72903-073
Phone: (479) 484-5901

The provider's authorized official is Glenna Marie Roe .
The authorized official title is Coder and has the following contact phone number (479) 484-5901.

The CLIA number assigned to this NPI record is 04D0701088 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 6/10/2006 and was last updated on 3/20/2024.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207V00000XObstetrics & GynecologyYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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