# HACKETT FAMILY CLINIC, LLC

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

## Provider details

- **NPI number:** 1124656434
- **Authorized official:** EVELYN M TUSTIN (OFFICE MANAGER)
- **Authorized official phone:** (479) 255-6095

## Contact information

- **Practice address:** 215 N MAIN ST, HACKETT, AR 72937-8801
- **Practice address phone:** (479) 255-6095
- **Practice address fax:** (479) 255-6141
- **Mailing address:** PO BOX 1278, POTEAU, OK 74953-1278
- **Mailing address phone:** (918) 647-0670
- **Mailing address fax:** (918) 647-0460

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 03/31/2020
- **Last updated:** 03/31/2020