# IRVIN & DIBRELL MEDICAL CLINIC, PA

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

## Provider details

- **NPI number:** 1669492575
- **Authorized official:** DR. JOHN D IRVIN M.D. (PRESIDENT)
- **Authorized official phone:** (870) 269-9800

## Contact information

- **Practice address:** 803 WEST MAIN, MOUNTAIN VIEW, AR 72560
- **Practice address phone:** (870) 269-9800
- **Practice address fax:** (870) 269-9614
- **Mailing address:** P. O. BOX 106, MOUNTAIN VIEW, AR 72560
- **Mailing address phone:** (870) 269-9800
- **Mailing address fax:** (870) 269-9614

## Taxonomy

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

## Other

- **Enumeration date:** 07/20/2006
- **Last updated:** 06/24/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 5C651 | BLUE CROSS BLUE SHIELD | AR |
| 01 | — | DB3125 | RAILROAD MEDICARE | AR |