| Chicot Memorial Medical Center Womens Clinic | |
|
2729 Hwy 65 & 82 S Lake Village AR 71653-6136 | |
| (870) 265-5351 | |
| (870) 265-2091 |
| Full Name | Chicot Memorial Medical Center Womens Clinic |
|---|---|
| Speciality | Clinic/center |
| Location | 2729 Hwy 65 & 82 S, Lake Village, Arkansas |
| Authorized Official Name and Position | Susan Vaughn (CFO) |
| Authorized Official Contact | 8702655351 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Chicot Memorial Medical Center Womens Clinic 2729 Hwy 65 & 82 S Lake Village AR 71653-6136 Ph: (870) 265-5351 | Chicot Memorial Medical Center Womens Clinic 2729 Hwy 65 & 82 S Lake Village AR 71653-6136 Ph: (870) 265-5351 |
| NPI Number | 1104238179 |
|---|---|
| Provider Enumeration Date | 05/27/2014 |
| Last Update Date | 07/09/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104238179 | NPI | - | NPPES |
| 181080105 | Medicaid | AR | |
| 04-Z328 | Other | MEDICARE PROVIDER NUMBER | |
| 04-1328 | Other | MEDICARE PROVIDER NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
Chicot Memorial Medical Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2729 Hwy 65 & 82 S, Lake Village, AR 71653 Phone: 870-265-5351 Fax: 870-265-2091 | |
Southeast Rural Health Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 608 S Highway 65 82, Lake Village, AR 71653 Phone: 870-265-4333 Fax: 318-665-9950 | |
Lake Village Clinic Pa Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2918 Louis Sessions St, Lake Village, AR 71653 Phone: 870-265-5343 Fax: 870-265-5686 | |
Ob Lake Village Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2729 Us 65, Lake Village, AR 71653 Phone: 870-466-4987 Fax: 855-926-7383 | |
Russell Medical Services Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5071 Highway 82 E, Lake Village, AR 71653 Phone: 870-515-1289 | |
The Functional Pharmacist Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 401 Main St, Lake Village, AR 71653 Phone: 870-265-6603 |