PHYSICIAN'S MANAGEMENT GROUP
NPI 1871756437
Psychologist - Intellectual and Developmental Disabilities in Jacksonville, AR
- Organization
- Psychologist
- Intellectual and Developmental Disabilit...
- CLIA Number: 04D2042678
- CLIA Cert. Type: Independent
- CLIA Exp. Date: 08-01-2027
About PHYSICIAN'S MANAGEMENT GROUP
This page provides the complete NPI Profile along with additional information for Physician's Management Group, a provider established in Jacksonville, Arkansas operating as a Psychologist, focusing in intellectual and developmental disabilities . The healthcare provider is registered in the NPI registry with number 1871756437 assigned on July 2008. The practitioner's primary taxonomy code is 103TM1800X with license number C5129 (AR). The provider is registered as an organization and their NPI record was last updated 18 years ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The authorized official of this NPI record is Dr. Robert Farrell Md (Ceo)
- NPI
- 1871756437 Verify this NPI
- Provider Name
- PHYSICIAN'S MANAGEMENT GROUP
- Entity Type
- Organization
- Location Address
- 2520 W MAIN ST JACKSONVILLE, AR 72076
- Location Phone
- (501) 982-0528
- Location Fax
- (501) 985-7777
- Mailing Address
- 501 N ELM ST LITTLE ROCK, AR 72205
- Mailing Phone
- (501) 663-4204
- Mailing Fax
- (501) 663-4233
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 07-03-2008
- Last Update Date
- 07-03-2008
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Psychologist Intellectual and Developmental Disabilities
- Taxonomy Code
- 103TM1800X
- Type
- Behavioral Health & Social Service Providers
- License No.
- C5129
- License State
- AR
Group Taxonomy 193400000X SINGLE SPECIALTY GROUP
This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 04D2042678
- Facility Type
- Independent
- Certificate Effective Date
- August 02, 2025
- Certificate Expiration Date
- August 01, 2027
- Laboratory Director
- JOSHUA BORNHORST
- Certificate Type
- Certificate of Compliance
- Certificate Type Description
- This CLIA certificate is issued to Physician's Management Group after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements. This type of certificate is issued to laboratories that perform nonwaived (moderate and/or high complexity) testing.
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Other Providers at the Same Location
The following 18 providers are registered at the same or a nearby location.
JACKSONVILLE, AR 72076
JACKSONVILLE, AR 72076
JACKSONVILLE, AR 72076
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1871756437, enumerated as an "organization" on July 03, 2008.
The provider is located at 2520 W MAIN ST JACKSONVILLE, AR 72076 and the phone number is (501) 982-0528.
Psychologist with taxonomy code 103TM1800X and a focus in Intellectual and Developmental Disabilities.
