Dermlogic, P.L.L.C, PA

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

E3291 Issued in AR

Legal business name

DERMLOGIC, P.L.L.C, PA

Practice address

9780 Maumelle Blvd
North Little Rock, AR 72113-6737

Phone

(501) 753-9000

Fax

(501) 753-9004

NPI assigned

Jun 7, 2012

Last updated

Jun 7, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Kim M Hiatt, M.D.

Title

Manager

Phone

(501) 551-6408

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1339027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1339027200000",
    "number": "1780946517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9780 MAUMELLE BLVD",
            "city": "NORTH LITTLE ROCK",
            "state": "AR",
            "postal_code": "721136737",
            "telephone_number": "501-753-9000",
            "fax_number": "501-753-9004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9780 MAUMELLE BLVD",
            "city": "NORTH LITTLE ROCK",
            "state": "AR",
            "postal_code": "721136737",
            "telephone_number": "501-753-9000",
            "fax_number": "501-753-9004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DERMLOGIC, P.L.L.C, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-07",
        "last_updated": "2012-06-07",
        "status": "A",
        "authorized_official_last_name": "HIATT",
        "authorized_official_first_name": "KIM",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "501-551-6408",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "AR",
            "license": "E3291",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Medical Laboratory in North Little Rock, AR
• Providers in North Little Rock, AR by specialty
• Clinical Medical Laboratory in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2012; 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.