| NPI | 1003040213 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH A HEILES Owner/Physician 870-628-5110 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AR R3681) |
| Enumeration Date | 2009-05-04 |
| Last Update Date | 2011-09-28 |