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202 Newsome Dr Marked Tree AR 72365-2021 | |
(870) 358-4355 | |
(870) 994-7488 |
Full Name | |
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Speciality | Clinic/Center |
Location | 202 Newsome Dr, Marked Tree, Arkansas |
Authorized Official Name and Position | Bradley Bibb (CEO) |
Authorized Official Contact | 8709947301 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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49 Highway 62 412 Ash Flat AR 72513-9594 Ph: (870) 994-7301 | 202 Newsome Dr Marked Tree AR 72365-2021 Ph: (870) 358-4355 |
NPI Number | 1831595057 |
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Provider Enumeration Date | 11/16/2014 |
Last Update Date | 02/03/2020 |
Medicare PECOS PAC ID | 4789715285 |
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Medicare Enrollment ID | O20141208001330 |
Identifier | Type | State | Issuer |
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1831595057 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |