| NPI | 1972740678 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FRANKIE WILLIAMS Practice Manager 870-633-0220 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QR1300X Clinic/Center Rural Health (Licence: AR R4242) |
| Additional Taxonomies | 208D00000X General Practice (Licence: AR R4242) |
| Enumeration Date | 2009-01-16 |
| Last Update Date | 2010-01-13 |