| Pcmc-conway Pa | |
|
1014 Harkrider St Suite B Conway AR 72032-4404 | |
| (501) 327-7100 | |
| (501) 327-7121 |
| Full Name | Pcmc-conway Pa |
|---|---|
| Speciality | Family Medicine |
| Location | 1014 Harkrider St, Conway, Arkansas |
| Authorized Official Name and Position | John Paul Wornock (PRESIDENT) |
| Authorized Official Contact | 5012799000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pcmc-conway Pa 1014 Harkrider St Suite B Conway AR 72032-4404 Ph: (501) 327-7100 | Pcmc-conway Pa 1014 Harkrider St Suite B Conway AR 72032-4404 Ph: (501) 327-7100 |
| NPI Number | 1871755421 |
|---|---|
| Provider Enumeration Date | 06/25/2008 |
| Last Update Date | 06/25/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871755421 | NPI | - | NPPES |
| 1386614097 | Medicaid | AR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | E1057 (Arkansas) | Primary |
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