| |
970 Ash Flat Dr Ash Flat AR 72513-0790 | |
(870) 994-7301 | |
(870) 994-7488 |
Full Name | |
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Speciality | Family Medicine |
Location | 970 Ash Flat Dr, Ash Flat, Arkansas |
Authorized Official Name and Position | Debra Henry (CFO) |
Authorized Official Contact | 8705081003 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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970 Ash Flat Dr Ash Flat AR 72513-0790 Ph: (870) 994-7301 | 970 Ash Flat Dr Ash Flat AR 72513-0790 Ph: (870) 994-7301 |
NPI Number | 1699945147 |
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Provider Enumeration Date | 03/11/2008 |
Last Update Date | 08/02/2017 |
Identifier | Type | State | Issuer |
---|---|---|---|
1699945147 | NPI | - | NPPES |
168205002 | Medicaid | AR |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | AR3827 (Arkansas) | Primary |