# UNIV OF ARK FOR MED SCIENCES DBA AHEC FAMILY PRACTICE CENTER INDEP LAB

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

## Provider details

- **NPI number:** 1477571933
- **Authorized official:** MRS. KATHLEEN WYLIE (OFFICE MANAGER)
- **Authorized official phone:** (870) 541-6008

## Contact information

- **Practice address:** 4010 S MULBERRY ST, PINE BLUFF, AR 71603-7000
- **Practice address phone:** (870) 541-6008
- **Practice address fax:** (870) 541-6034
- **Mailing address:** 4010 S MULBERRY ST, PINE BLUFF, AR 71603-7000
- **Mailing address phone:** (870) 541-6008
- **Mailing address fax:** (870) 541-6034

## Taxonomy

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

## Other

- **Enumeration date:** 07/17/2006
- **Last updated:** 08/22/2020