| NPI | 1043965734 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES ROBERT MCWILLIAMS Owner 479-437-6080 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2022-02-21 |
| Last Update Date | 2022-02-21 |