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Organization
ARKANSAS CENTRAL PRIMARY CARE, PLLC
Active
Organization
ARKANSAS CENTRAL PRIMARY CARE, PLLC
Active
Other names
Jacksonville Medical Care
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GARY DREW JACKSON (CLINIC ADMINISTRATOR)
(501) 985-5994
Entity
Organization
Contact information
Practice address
1300 BRADEN ST., JACKSONVILLE, AR 72076-3719
(501) 985-5900
(501) 985-6016
Mailing address
PO BOX 309, JACKSONVILLE, AR 72078-0309
(501) 985-5900
(501) 985-6016
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
208D00000X
General Practice Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
142734002
—
AR
05
—
176116002
—
AR
Enumeration date
10/03/2008
Last updated
02/02/2011
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