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Organization
HACKETT FAMILY CLINIC, LLC
Active
Organization
HACKETT FAMILY CLINIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EVELYN M TUSTIN (OFFICE MANAGER)
(479) 255-6095
Entity
Organization
Contact information
Practice address
215 N MAIN ST, HACKETT, AR 72937-8801
(479) 255-6095
(479) 255-6141
Mailing address
PO BOX 1278, POTEAU, OK 74953-1278
(918) 647-0670
(918) 647-0460
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
03/31/2020
Last updated
03/31/2020
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