PEDIATRIC AND TEEN MEDICAL CENTER
NPI 1053490144
Specialist in Blytheville, AR

Active since November 02, 2006
1521 N 10TH ST, SUITE H, BLYTHEVILLE, AR 72315(870) 763-1700(870) 763-2903 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Pediatric And Teen Medical Center NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PEDIATRIC AND TEEN MEDICAL CENTER (NPI 1053490144) is a healthcare organization registered as a specialist in Blytheville, Arkansas and active in the NPI registry since November 2006. The organization lists Anes Wiley Abraham, President, as its authorized official.

NPPES Registry Identity

NPI1053490144
Entity TypeOrganization
Primary Taxonomy174400000X
Legal Business NameANES W. ABRAHAM M.D. P.A.
Location Address1521 N 10TH ST, SUITE HBlytheville, AR 72315-1405
Mailing Address1521 N 10th St, Suite HBlytheville, AR 72315-1405 · (870) 763-1700 · Fax (870) 763-2903
Fax(870) 763-2903
Organization SubpartNo
Authorized OfficialAnes Wiley AbrahamPresident · (870) 763-1700
Enumeration DateNovember 2, 2006
Last NPPES UpdateAugust 22, 2020
NPI 1053490144 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
License Licensed in AR · R3291
Definition

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

1521 N 10TH ST, Blytheville, AR 72315

Other Names 1

Doing Business AsPediatric And Teen Medical Center

Other Identifiers 1

Other57920AR · Clinic Bcbs

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 8

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Internal Medicine (Critical Care Medicine)
1521 N 10TH ST, SUITE D
BLYTHEVILLE, AR 72315
Pediatrics
1521 N 10TH ST, SUITE C
BLYTHEVILLE, AR 72315
Specialist
1521 N 10TH ST
BLYTHEVILLE, AR 72315
Internal Medicine
1521 N 10TH ST, STE C
BLYTHEVILLE, AR 72315
Pediatrics
1521 N 10TH ST, STE F
BLYTHEVILLE, AR 72315
General Practice
1521 N 10TH ST, STE C
BLYTHEVILLE, AR 72315
Family Medicine
1521 N 10TH ST, STE C
BLYTHEVILLE, AR 72315
Nurse Practitioner (Family)
1521 N 10TH ST, SUITE C
BLYTHEVILLE, AR 72315

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Anes W. Abraham M.D. P.A.'s NPI number?

The NPI number for Anes W. Abraham M.D. P.A. is 1053490144. It was assigned to this organization in the NPPES registry on November 2, 2006. The provider is doing business as Pediatric And Teen Medical Center.

Where is Anes W. Abraham M.D. P.A. located?

Anes W. Abraham M.D. P.A. is located at 1521 N 10th St Suite H, Blytheville, AR 72315. The listed phone number is (870) 763-1700.

What is Anes W. Abraham M.D. P.A.'s specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

When was this NPI record last updated?

The NPPES record for Anes W. Abraham M.D. P.A. was last updated on August 22, 2020. NPI Profile syncs with the weekly NPPES data releases published by CMS.