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MONTICELLO MEDICAL CLINIC PLC NPI 1982193975


NPI Information

NPI: 1982193975
Provider Name: MONTICELLO MEDICAL CLINIC, PLC

Other Name: MMC-STAR CITY SATELLITE CLINIC

Classification: Family Medicine - 207Q00000X
Entity Type: Organization
Address:
1306 N. LINCOLN AVENUE
STAR CITY, AR
ZIP 71667
Phone: (870) 628-1388
Get Directions

MONTICELLO MEDICAL CLINIC, PLC is a family medicine in Star City, AR. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. MONTICELLO MEDICAL CLINIC, PLC NPI is 1982193975. The provider is registered as an organization entity type and is a single specialty group.
The provider Other Name Is Mmc-star City Satellite Clinic.

The provider's business location address is:

1306 N. LINCOLN AVENUE
STAR CITY, AR
ZIP 71667
Phone: (870) 628-1388
Fax: (870) 628-1347

The provider's authorized official is Sylvia Simon .
The authorized official title is Medical Director and has the following contact phone number (870) 367-6867.

The enumeration date for this NPI number is 5/4/2018 and was last updated on 5/4/2018.


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:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207Q00000XFamily MedicineMC-1891ARKANSASYes

Other Identifiers

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

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1139812002MEDICAIDARKANSAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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