# RUSSELLVILLE WOMEN'S CLINIC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1093774671
- **Authorized official:** JOE CLOUD M.D. (CO-OWNER)
- **Authorized official phone:** (479) 968-1011

## Contact information

- **Practice address:** 200 N QUANAH AVE, RUSSELLVILLE, AR 72801-2762
- **Practice address phone:** (479) 968-1011
- **Mailing address:** 200 N QUANAH AVE, RUSSELLVILLE, AR 72801-2762
- **Mailing address phone:** (479) 968-1011

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | — | NULL | Yes |
| 207V00000X | Obstetrics & Gynecology Physician | — | — | Yes |

## Other

- **Enumeration date:** 03/21/2006
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 57692 | ARK BLUECROSS | AR |