| NPI | 1427236926 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARL R MAGNESS Owner/Physician 479-521-1114 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: AR C4954) |
| Enumeration Date | 2008-02-06 |
| Last Update Date | 2008-02-06 |