# CROWLEYS RIDGE FAMILY PRACTICE LLC

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

## Provider details

- **NPI number:** 1578676045
- **Authorized official:** DAVID M COSS M.D. (OWNER)
- **Authorized official phone:** (870) 630-1683

## Contact information

- **Practice address:** 904 HOLIDAY DR, SUITE 404, FORREST CITY, AR 72335-9183
- **Practice address phone:** (870) 630-1683
- **Practice address fax:** (870) 630-0308
- **Mailing address:** 904 HOLIDAY DR, SUITE 404, FORREST CITY, AR 72335-9183
- **Mailing address phone:** (870) 630-1683
- **Mailing address fax:** (870) 630-0308

## Taxonomy

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

## Other

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