| NPI | 1225083181 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHY LYNN MAYHEW Owner/President 479-770-0221 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AR E-0305) |
| Enumeration Date | 2006-05-22 |
| Last Update Date | 2020-08-22 |