Great River Pediatric Clinic
Pediatrics
Great River Pediatric Clinic is a Blytheville, Arkansas based Pediatric center with medical specialization in
General Pediatrics.
It is located at
1521 N 10th St, Ste F, Blytheville, Arkansas - 72315-1405. They can be contacted on phone at
870-780-6832 and fax number 870-780-6919.
NPI number (Unique professional ID) for Great River Pediatric Clinic is
1467586131 which was assigned by NPPES on 15 Mar, 2007 and it was last updated on 22 Aug, 2020.
Great River Pediatric Clinic license number is
E-4133 for Pediatrics (208000000X) in Arkansas.
Great River Pediatric Clinic is a pediatrician who is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
Complete Profile:
Great River Pediatric Clinic basic information including their official name, gender, specialization, credentials etc. are as mentioned below.
| Specialization : | Pediatrics |
|---|
| Provider Name : | Great River Pediatric Clinic |
|---|
Business Address:
Great River Pediatric Clinic address, contact phone number and fax are as below. Patients can directly walkin to the clinic or can call on the below given phone number for appointment.
| Primary Address : | 1521 N 10th St, Ste F
Blytheville, AR, 72315-1405
United States |
|---|
| Phone Number : | 870-780-6832 |
|---|
| Fax Number : | 870-780-6919 |
|---|
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). NPI details are as mentioned below.
| NPI Number : | 1467586131 |
|---|
| NPI Entity Type : | Organization |
|---|
| First Enrolment Date : | 15 Mar, 2007 |
|---|
| Last Updated On : | 22 Aug, 2020 |
|---|
Authorized Official Details:
Officially authorized person to contact for any management issues or complaints of this organization are as below. Person's position and contact details are as mentioned below.
| Authorized Official Name : | Benjamin Asafo-boakye |
|---|
| Authorized Official Credential : | M.D., MPH, FAAP |
|---|
| Official Title or Position : | PEDIATRICIAN |
|---|
| Phone Number : | 870-780-6832 |
|---|
Licenses and Specialities:
Physicians/Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Great River Pediatric Clinic are as mentioned. Primary taxonomy code for Great River Pediatric Clinic is
208000000X (Pediatrics).
| Taxonomy Code | Speciality | Primary | License No. | State |
|---|
| 208000000X | Pediatrics | Yes | E-4133 | AR |
Legacy Identifiers:
Other legacy medical identifiers of Great River Pediatric Clinic such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned below.
| Identifier | Identifier Type | State | Issuer |
|---|
| 5F511 | Other | AR | BLUE CROSS BLUE SHIELD |
Mailing Address:
Mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned business address only.
| Mailing Address : | 1521 N 10th St, Ste F
Blytheville, AR, 72315-1405
United States |
|---|
| Phone Number : | 870-780-6832 |
|---|
| Fax Number : | 870-780-6919 |
|---|
Business Location:
Patients can refer following map for directions to
Great River Pediatric Clinic practice address. Don't forget to take prior appointment before visiting.
** Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 08 January, 2024.