Provider Demographics
NPI:1477166361
Name:SUPERIOR PEDIATRICS, PLLC
Entity Type:Organization
Organization Name:SUPERIOR PEDIATRICS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:ALINE
Authorized Official - Last Name:TURPEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:870-358-1400
Mailing Address - Street 1:PO BOX 14
Mailing Address - Street 2:
Mailing Address - City:MARKED TREE
Mailing Address - State:AR
Mailing Address - Zip Code:72365-0014
Mailing Address - Country:US
Mailing Address - Phone:870-358-1400
Mailing Address - Fax:
Practice Address - Street 1:100 DAWSON ST
Practice Address - Street 2:
Practice Address - City:MARKED TREE
Practice Address - State:AR
Practice Address - Zip Code:72365-2221
Practice Address - Country:US
Practice Address - Phone:870-358-1400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-28
Last Update Date:2020-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty