Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

College Park Family Clinic PA

Organization Emergency Medicine Physician · NPI 1861478232

College Park Family Clinic PA is an Emergency Medicine Physician in Conway, Arkansas. Licensed in Arkansas. Registered with an NPI since 2005.

Licensed in
AR
In the registry since
2005
Specialties on file
3
What do these letters mean?
PA — Professional association
A form of business registration, not a clinical qualification.

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Practice location Address checks out

2511-A College Ave
Conway, AR 72034
Phone: (501) 327-6041
Fax: (501) 327-6043
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Emergency Medicine Physician (primary) Taxonomy 207P00000X · Licence C6340 (AR)
Family Medicine Physician Taxonomy 207Q00000X · Licence C6340 (AR)
Pediatrics Physician Taxonomy 208000000X · Licence C6340 (AR)

Record details

NPI number1861478232
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Gil Johnson — Ceo President · (501) 327-6041
NPI enumeratedDecember 19, 2005
Last updated in NPPESSeptember 11, 2025
Mailing address2511-A College Ave, Conway, AR 72034

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