Provider Demographics
NPI:1851436117
Name:PINNACLE FAMILY MEDICINE, P.A.
Entity Type:Organization
Organization Name:PINNACLE FAMILY MEDICINE, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:WEBB
Authorized Official - Last Name:CROWELL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:501-975-1915
Mailing Address - Street 1:11321 INTERSTATE 30
Mailing Address - Street 2:SUITE 202
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72209-7040
Mailing Address - Country:US
Mailing Address - Phone:501-975-1915
Mailing Address - Fax:501-975-1917
Practice Address - Street 1:11321 INTERSTATE 30
Practice Address - Street 2:SUITE 202
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72209-7040
Practice Address - Country:US
Practice Address - Phone:501-975-1915
Practice Address - Fax:501-975-1917
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARBL136578261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
5F210Medicare ID - Type Unspecified