| Full Name | |
|---|---|
| Speciality | Clinic/center - Rural Health |
| Location | 115 Turner Ln, Salem, Arkansas |
| Authorized Official Name and Position | Monya York (CONTROLLER) |
| Authorized Official Contact | 8708561202 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
4196 Highway 62 412 Ste A Hardy AR 72542-8002 Ph: () - | 115 Turner Ln Salem AR 72576-5600 Ph: (870) 895-3238 |
| NPI Number | 1568200061 |
|---|---|
| Provider Enumeration Date | 07/18/2024 |
| Last Update Date | 01/23/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568200061 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
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