# COTNER MEDICAL CLINIC

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

## Provider details

- **NPI number:** 1669431326
- **Authorized official:** J. BRIAN COTNER M.D. (OWNER)
- **Authorized official phone:** (479) 754-9945

## Contact information

- **Practice address:** 25 PROFESSIONAL PARK DR, CLARKSVILLE, AR 72830-4432
- **Practice address phone:** (479) 754-9945
- **Practice address fax:** (479) 754-9947
- **Mailing address:** PO BOX 336, CLARKSVILLE, AR 72830-0336
- **Mailing address phone:** (479) 754-9945
- **Mailing address fax:** (479) 754-9947

## Taxonomy

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

## Other

- **Enumeration date:** 03/21/2006
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 5C879 | ARK BLUECROSS | AR |