RICH MOUNTAIN WOMENS CLINIC NPI 1861631723

NPI Information

RICH MOUNTAIN WOMENS CLINIC is a specialist in Mena, AR. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. RICH MOUNTAIN WOMENS CLINIC NPI is 1861631723. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

403 MORROW ST N STE A
MENA, AR
ZIP 71953-324
Phone: (479) 394-4595
Fax: (479) 394-1140

The provider's authorized official is John D. Mesko .
The authorized official title is Doctor and has the following contact phone number (479) 394-4595.

The CLIA number assigned to this NPI record is 04D0466062 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 2/16/2009 and was last updated on 2/16/2009.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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