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Organization
MEDICAL CENTER CLINIC OF IZARD COUNTY LLC
Active
Organization
MEDICAL CENTER CLINIC OF IZARD COUNTY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DONALD O. WRIGHT M.D. (CHIEF OF STAFF)
(870) 297-2475
Entity
Organization
Contact information
Practice address
35 GRASSE STREET, CALICO ROCK, AR 72519
(870) 297-2475
(870) 297-4380
Mailing address
PO BOX 819, CALICO ROCK, AR 72519-0819
(870) 297-2475
(870) 297-4380
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
—
NULL
207L00000X
Anesthesiology Physician
—
—
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
NULL
207R00000X
Internal Medicine Physician
—
—
208600000X
Surgery Physician
—
NULL
208600000X
Surgery Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
137324002
—
AR
01
—
5C216
BLUE CROSS BLUE SHIELD
—
01
—
93492
HEALTH PARTNERS
—
Enumeration date
02/28/2006
Last updated
04/03/2012
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