KEYSTONE FAMILY CLINIC NPI 1205280021

NPI Information

KEYSTONE FAMILY CLINIC is a primary care clinic center in Fort Smith, AR. KEYSTONE FAMILY CLINIC NPI is 1205280021. The provider is registered as an organization entity type.

The provider's business location address is:

9207 HIGHWAY 71 S
SUITE 9
FORT SMITH, AR
ZIP 72916-117
Phone: (479) 434-6140

The provider's authorized official is Joshua Aaron Clark .
The authorized official title is Owner and has the following contact phone number (479) 434-6140.

The CLIA number assigned to this NPI record is 04D2113315 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/18/2016 and was last updated on 9/22/2016.

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:

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