Provider Demographics
NPI:1518748367
Name:ARKANSAS VEIN CARE CLINICS LLC
Entity Type:Organization
Organization Name:ARKANSAS VEIN CARE CLINICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ADNAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SADIQ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:571-206-5444
Mailing Address - Street 1:100 SHADOW OAKS DR
Mailing Address - Street 2:
Mailing Address - City:SHERWOOD
Mailing Address - State:AR
Mailing Address - Zip Code:72120-6046
Mailing Address - Country:US
Mailing Address - Phone:571-206-5444
Mailing Address - Fax:571-206-5444
Practice Address - Street 1:100 SHADOW OAKS DR
Practice Address - Street 2:
Practice Address - City:SHERWOOD
Practice Address - State:AR
Practice Address - Zip Code:72120-6046
Practice Address - Country:US
Practice Address - Phone:571-206-5444
Practice Address - Fax:571-206-5444
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-09
Last Update Date:2023-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty