# HUNTSVILLE MEDICAL CLINIC, LLC

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

## Provider details

- **NPI number:** 1457226706
- **Authorized official:** GINA DICKEY APRN (MANAGER)
- **Authorized official phone:** (479) 738-1700

## Contact information

- **Practice address:** 705 PHILLIPS PL, PO BOX 860, HUNTSVILLE, AR 72740
- **Practice address phone:** (479) 738-1700
- **Practice address fax:** (479) 738-5510
- **Mailing address:** PO BOX 860, HUNTSVILLE, AR 72740-0860
- **Mailing address phone:** (479) 738-1700
- **Mailing address fax:** (479) 738-5510

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 363LF0000X | Family Nurse Practitioner | — | NULL | — |
| 363LF0000X | Family Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 10/07/2025
- **Last updated:** 11/26/2025