# MOUNTAIN-HOME MEDICAL GROUP, PA

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Mtn Home Medical Group PA
- **Organization subpart:** No

## Provider details

- **NPI number:** 1225087398
- **Authorized official:** MRS. MAXWELL G CHENEY MD (OWNER)
- **Authorized official phone:** (870) 425-3125

## Contact information

- **Practice address:** 353 EAST 8TH STREET, MOUNTAIN HOME, AR 72653
- **Practice address phone:** (870) 425-3125
- **Practice address fax:** (870) 424-5059
- **Mailing address:** PO BOX 1836, MOUNTAIN HOME, AR 72654-1836
- **Mailing address phone:** (870) 425-3125
- **Mailing address fax:** (870) 424-5059

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | MC0049 | AR | — |
| 207R00000X | Internal Medicine Physician | MC0049 | AR | Yes |

## Other

- **Enumeration date:** 05/08/2006
- **Last updated:** 04/14/2011