Chenal Family Practice in Little Rock - Medical Specialty
Chenal Family Practice - NPI 1013066513
Chenal Family Practice is a Medical Specialty in Little Rock, Arkansas. Chenal Family Practice practices all healthcare services and medical treatments related to Medical Specialty. The NPI Number for Chenal Family Practice is 1013066513. The last update date is 2010-11-03.
Chenal Family Practice's current location address is 11215 Hermitage Rd, Little Rock, Arkansas. You can contact this provider via phone number 5012191929 and fax number 5012190021. The mailing address for Chenal Family Practice is 11215 Hermitage Rd, Little Rock, Arkansas. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Chenal Family Practice |
|---|---|
| Address | 11215 Hermitage Rd, Little Rock, Arkansas |
| Phone Number | 5012191929 |
| Fax Number | 5012190021 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | DOCTOR |
|---|---|
| Authorized Official Name | Kennedy Bruce Robert |
| Credentials | MD |
| Telephone Number | 5012191929 |
NPI Number Detail
| NPI Number | 1013066513 |
|---|---|
| Provider Enumeration Date | 2007-01-10 |
| Last Updated Date | 2010-11-03 |
Provider Mailing Address Detail
| Address | 11215 Hermitage Rd |
|---|---|
| City | Little Rock |
| State | Arkansas (AR) |
| Post Code | 722113863 |
| Phone Number | 5012191929 |
| Fax Number | 5012190021 |
Provider's Primary Taxonomy Detail
| Speciality | Medical Specialty |
|---|---|
| Taxonomy | 261Qm2500X |
| Licence No | 1398 |
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Definition: An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific |
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What is the unique 10-digit identification code assigned to Chenal Family Practice by the Centers for Medicare & Medicaid Services?
The Chenal Family Practice has been issued the NPI (National Provider Identifier) 1013066513, which serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you please provide the complete street address where Chenal Family Practice is physically located?
The Chenal Family Practice is physically situated at the following address: 11215 Hermitage Rd, Little Rock, AR, 722113863.
What is the Chenal Family Practice's specialty and taxonomy code?
The Chenal Family Practice's specialty is Medical Specialty, and the corresponding taxonomy code is 261Qm2500X.
On what date did the Chenal Family Practice receive its 1013066513 assignment from the Centers for Medicare & Medicaid Services?
The Chenal Family Practice was assigned its 1013066513 by the Centers for Medicare & Medicaid Services on 2007-01-10.
When was the information regarding Chenal Family Practice, such as address, specialty, and other details, most recently verified or confirmed to be accurate?
The information pertaining to Chenal Family Practice, including its address, specialty, and other relevant details, was most recently verified or confirmed to be accurate on 2010-11-03.