# WESTERN ARKANSAS PRIMARY CARE

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** WESTERN ARKANSAS PRIMARY CARE
- **Other names:** Western Arkansas Primary Care 2
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1598186009
- **Legal business name:** WESTERN ARKANSAS PRIMARY CARE
- **Authorized official:** DR. LONNIE J PARKER MD (PRESIDENT)
- **Authorized official phone:** (479) 965-8888

## Contact information

- **Practice address:** 1069 S SHARPE AVE, BOONEVILLE, AR 72927-4683
- **Practice address phone:** (479) 965-8888
- **Practice address fax:** (479) 965-8889
- **Mailing address:** 2617 E MAIN ST, CHARLESTON, AR 72933-9637
- **Mailing address phone:** (479) 965-8888
- **Mailing address fax:** (479) 965-8889

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | E1887 | AR | Yes |

## Other

- **Enumeration date:** 12/31/2013
- **Last updated:** 12/31/2013

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1336577238 | TRICARE | AR |