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Organization
WESTERN ARKANSAS PRIMARY CARE
Active
Organization
WESTERN ARKANSAS PRIMARY CARE
Active
Parent organization
WESTERN ARKANSAS PRIMARY CARE
Other names
Western Arkansas Primary Care 2
Organization subpart
Yes
Provider details
NPI number
Legal business name
WESTERN ARKANSAS PRIMARY CARE
Authorized official
DR. LONNIE J PARKER MD (PRESIDENT)
(479) 965-8888
Entity
Organization
Contact information
Practice address
1069 S SHARPE AVE, BOONEVILLE, AR 72927-4683
(479) 965-8888
(479) 965-8889
Mailing address
2617 E MAIN ST, CHARLESTON, AR 72933-9637
(479) 965-8888
(479) 965-8889
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
E1887
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1336577238
TRICARE
AR
Enumeration date
12/31/2013
Last updated
12/31/2013
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