Full Name | |
---|---|
Speciality | Family Medicine |
Location | 205 Wolf St, Pearcy, Arkansas |
Authorized Official Name and Position | Brenda Larie Southerland (CFO) |
Authorized Official Contact | 5016257500 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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1661 Airport Rd Ste D Hot Springs AR 71913-8184 Ph: (501) 625-7500 | 205 Wolf St Pearcy AR 71964-9449 Ph: (501) 767-2306 |
NPI Number | 1962004093 |
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Provider Enumeration Date | 11/13/2020 |
Last Update Date | 12/10/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1962004093 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |