| |
104 E Columbia Magnolia AR 71753-2436 | |
(870) 862-2489 | |
Not Available |
Full Name | |
---|---|
Speciality | Clinic/Center |
Location | 104 E Columbia, Magnolia, Arkansas |
Authorized Official Name and Position | Melony Goodhand (VICE CHANCELLOR FOR FINANCE AND CFO) |
Authorized Official Contact | 5016865671 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
4301 West Markham Street., Slot# 599 Little Rock AR 72205-7199 Ph: (501) 686-5264 | 104 E Columbia Magnolia AR 71753-2436 Ph: (870) 862-2489 |
NPI Number | 1841557725 |
---|---|
Provider Enumeration Date | 04/18/2012 |
Last Update Date | 04/18/2012 |
Medicare PECOS PAC ID | 4082528955 |
---|---|
Medicare Enrollment ID | O20121128000338 |
Identifier | Type | State | Issuer |
---|---|---|---|
1841557725 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | (Arkansas) | Primary |
Fred Y Murphy Md Pa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1010 N Dudney Rd, Ste C, Magnolia, AR 71753 Phone: 870-234-7101 Fax: 870-234-7717 | |
Southern Medical Group Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 211 E Stadium, Magnolia, AR 71753 Phone: 870-234-5995 Fax: 870-234-0278 | |