NPI 1013047356

Waldron Place Pediatric Clinic, INC

Organisation Clinic/Center Fort Smith, AR

Practice location

Address: 1501 S Waldron Rd STE 202, Fort Smith, AR 72903-2598
Phone: (479) 452-8311
Fax: (479) 452-5032

Authorised official

Name: Federico Carlos de Miranda
Title: Owner
Phone: (479) 452-8311

Registered specialties

Clinic/Center Primary

Ambulatory Health Care Facilities Taxonomy 261Q00000X Licence C-5393 (AR)

Other Clinic/Center providers in Arkansas →

Registry record

NPI: 1013047356
Entity type: Organization
NPI issued: 6 Mar 2007
Record last updated: 22 Aug 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.