# RUSSELLVILLE HOLDINGS, LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** RUSSELLVILLE HOLDINGS, LLC
- **Other names:** (Part B)
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1013100890
- **Legal business name:** RUSSELLVILLE HOLDINGS, LLC
- **Authorized official:** TERRANCE DILLON (ASSISTANT SECRETARY)
- **Authorized official phone:** (502) 596-7220

## Contact information

- **Practice address:** 11720 STATE ROUTE 27, HECTOR, AR 72843
- **Practice address phone:** (479) 284-5001
- **Mailing address:** 4000 MERIDIAN BLVD, FRANKLIN, TN 37067-6325

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | — | — | Yes |

## Other

- **Enumeration date:** 08/24/2007
- **Last updated:** 03/29/2022