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MCCRORY FAMILY CLINIC PA NPI 1972613743


NPI Information

NPI: 1972613743
Provider Name: MCCRORY FAMILY CLINIC PA
Classification: Clinic/Center - 261QR1300X
Entity Type: Organization

Specialization: Rural Health

Address:
908 N EDMONDS AVE
MCCRORY, AR
ZIP 72101
Phone: (870) 731-1100
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MCCRORY FAMILY CLINIC PA is a rural health clinic center in Mccrory, AR. MCCRORY FAMILY CLINIC PA NPI is 1972613743. The provider is registered as an organization entity type.

The provider's business location address is:

908 N EDMONDS AVE
MCCRORY, AR
ZIP 72101
Phone: (870) 731-1100
Fax: (870) 731-1019

The provider's authorized official is Fred E Wilson .
The authorized official title is Md and has the following contact phone number (870) 731-1100.

The enumeration date for this NPI number is 8/30/2006 and was last updated on 6/9/2008.


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
1261QR1300XClinic/CenterRural HealthMC-1803ARKANSASYes

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
1CI5031OTHERARKANSASRAILROAD MEDICARE
2043844MEDICARE ID-TYPE UNSPECIFIEDARKANSASRURAL HEALTH MEDICARE #
3134474729MEDICAIDARKANSAS
45C026MEDICARE ID-TYPE UNSPECIFIEDARKANSAS
5134056002MEDICAIDARKANSAS

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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