Throneberry Family Clinic, P.a. | |
2869 College Ave Conway AR 72034-6087 | |
(501) 327-2611 | |
(501) 336-9763 |
Full Name | Throneberry Family Clinic, P.a. |
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Speciality | Clinic/Center |
Location | 2869 College Ave, Conway, Arkansas |
Authorized Official Name and Position | James Barton Throneberry (OWNER) |
Authorized Official Contact | 5013272611 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Throneberry Family Clinic, P.a. 2869 College Ave Conway AR 72034-6087 Ph: (501) 327-2611 | Throneberry Family Clinic, P.a. 2869 College Ave Conway AR 72034-6087 Ph: (501) 327-2611 |
NPI Number | 1538296256 |
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Provider Enumeration Date | 02/28/2007 |
Last Update Date | 05/04/2021 |
Medicare PECOS PAC ID | 6507874815 |
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Medicare Enrollment ID | O20110613000587 |
Identifier | Type | State | Issuer |
---|---|---|---|
1538296256 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261Q00000X | Clinic/center | MC1741 (Arkansas) | Primary |
Provider Name | James Throneberry |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1316949308 PECOS PAC ID: 2769444751 Enrollment ID: I20060328000381 |
Provider Name | Brandon M. Thurow |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1033346358 PECOS PAC ID: 4688853203 Enrollment ID: I20110127000674 |
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