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2713 S 74th St Ste 301 Mercy Tower Fort Smith AR 72903-5155 | |
(479) 434-3727 | |
Not Available |
Full Name | |
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Speciality | Clinic/center |
Location | 2713 S 74th St Ste 301, Fort Smith, Arkansas |
Authorized Official Name and Position | Amy Lee Plunkett (BUSINESS OWNER) |
Authorized Official Contact | 4794343727 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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2713 S 74th St Ste 301 Mercy Tower Fort Smith AR 72903-5155 Ph: (479) 434-3727 | 2713 S 74th St Ste 301 Mercy Tower Fort Smith AR 72903-5155 Ph: (479) 434-3727 |
NPI Number | 1801172937 |
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Provider Enumeration Date | 11/03/2011 |
Last Update Date | 11/03/2011 |
Identifier | Type | State | Issuer |
---|---|---|---|
1801172937 | NPI | - | NPPES |
200041850A | Medicaid | OK | |
154408758 | Medicaid | AR |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | 34110000101 (Arkansas) | Primary |
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