Suphan Medical Clinic

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

R-2871 Issued in AR

Legal business name

SUPHAN MEDICAL CLINIC

Practice address

11811 Hinson Rd Ste 200
Little Rock, AR 72212-3404

Phone

(501) 225-7500

Fax

(501) 225-7510

NPI assigned

Aug 7, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Neema G. Suphan

Title

Physician

Phone

(501) 225-7500

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1186444800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1186444800000",
    "number": "1679764419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11811 HINSON RD STE 200",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722123404",
            "telephone_number": "501-225-7500",
            "fax_number": "501-225-7510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11811 HINSON RD STE 200",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722123404",
            "telephone_number": "501-225-7500",
            "fax_number": "501-225-7510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUPHAN MEDICAL CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-07",
        "last_updated": "2007-08-07",
        "status": "A",
        "authorized_official_last_name": "SUPHAN",
        "authorized_official_first_name": "NEEMA",
        "authorized_official_middle_name": "G.",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "501-225-7500",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "R-2871",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Little Rock, AR
• Providers in Little Rock, AR by specialty
• Family Medicine Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.