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Organization
FAITH AND FAMILY MEDICAL PROVIDERS PLLC
Active
Organization
FAITH AND FAMILY MEDICAL PROVIDERS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACQUELYN BLADDICK (HUMAN RESOURCES)
(479) 310-5206
Entity
Organization
Contact information
Practice address
363 HIGHWAY 371 S, MAGNOLIA, AR 71753-8960
(573) 202-4070
Mailing address
363 HIGHWAY 371 S, MAGNOLIA, AR 71753-8960
(479) 310-5206
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
261QA0005X
Ambulatory Family Planning Facility
—
—
261QF0050X
Non-Surgical Family Planning Clinic/Center
—
—
Other
Enumeration date
05/05/2022
Last updated
07/11/2022
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