Provider Demographics
NPI:1982737169
Name:NICK PASLIDIS MD PA CENTRAL ARKANSAS INTERNAL MEDICINE CONSUTLING
Entity Type:Organization
Organization Name:NICK PASLIDIS MD PA CENTRAL ARKANSAS INTERNAL MEDICINE CONSUTLING
Other - Org Name:INTERNAL MED CONSULTING CENT AR
Other - Org Type:Other Name
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:NICK
Authorized Official - Middle Name:J
Authorized Official - Last Name:PASLIDIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:501-223-9948
Mailing Address - Street 1:375 EL CAMINO RD
Mailing Address - Street 2:
Mailing Address - City:SEDONA
Mailing Address - State:AZ
Mailing Address - Zip Code:86336-5122
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:821 E PARK HWY 70
Practice Address - Street 2:
Practice Address - City:CARLILSE
Practice Address - State:AR
Practice Address - Zip Code:72024
Practice Address - Country:US
Practice Address - Phone:501-223-9948
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-14
Last Update Date:2020-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE0216207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR126382001Medicaid
5B773Medicare ID - Type Unspecified
ARF93660Medicare UPIN