Provider Demographics
NPI:1285861013
Name:PILLOW CLINIC, PLLC
Entity Type:Organization
Organization Name:PILLOW CLINIC, PLLC
Other - Org Name:PILLOW CLINIC @ MARVELL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CLINIC MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TARA
Authorized Official - Middle Name:
Authorized Official - Last Name:ADAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:870-572-5996
Mailing Address - Street 1:1008 MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:MARVELL
Mailing Address - State:AR
Mailing Address - Zip Code:72366
Mailing Address - Country:US
Mailing Address - Phone:870-829-2521
Mailing Address - Fax:870-829-2941
Practice Address - Street 1:1008 MAIN STREET
Practice Address - Street 2:
Practice Address - City:MARVELL
Practice Address - State:AR
Practice Address - Zip Code:72366
Practice Address - Country:US
Practice Address - Phone:870-829-2521
Practice Address - Fax:870-829-2941
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PILLOW CLINIC , PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-06-19
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty