# FAMILY MEDICAL CARE, PA

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

## Provider details

- **NPI number:** 1255371753
- **Authorized official:** DR. GRANVILLE LEROY VAUGHAN III M.D. (OWNER/CEO)
- **Authorized official phone:** (501) 362-0048

## Contact information

- **Practice address:** 2225 HIGHWAY 110 W, HEBER SPRINGS, AR 72543-3404
- **Practice address phone:** (501) 362-0048
- **Practice address fax:** (501) 362-8815
- **Mailing address:** PO BOX 1018, 2225 HIGHWAY 110 WEST, HEBER SPRINGS, AR 72543-1018
- **Mailing address phone:** (501) 362-0048
- **Mailing address fax:** (501) 362-8815

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | C7548 | AR | Yes |

## Other

- **Enumeration date:** 06/07/2006
- **Last updated:** 07/30/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 080191764 | RAILROAD MEDICARE | AR |
| 05 | — | 149045002 | — | AR |