Provider Demographics
NPI:1134542434
Name:KARAS FAMILY WALK IN CLINIC
Entity type:Organization
Organization Name:KARAS FAMILY WALK IN CLINIC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:A
Authorized Official - Last Name:SOUTHERN
Authorized Official - Suffix:
Authorized Official - Credentials:RMA
Authorized Official - Phone:479-966-5088
Mailing Address - Street 1:767 W NORTH ST
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72701-1865
Mailing Address - Country:US
Mailing Address - Phone:479-966-5088
Mailing Address - Fax:186-676-0004
Practice Address - Street 1:767 W NORTH ST
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72701-1865
Practice Address - Country:US
Practice Address - Phone:479-966-5088
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-23
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR208178002Medicaid
AR208165002Medicaid
AR208163002Medicaid