# COWHERD FAMILY MEDICAL CENTER, PA

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

## Provider details

- **NPI number:** 1780622241
- **Authorized official:** BETH CLEGG CPC (CODER/BILLING ADMINISTRATOR)
- **Authorized official phone:** (501) 362-0500

## Contact information

- **Practice address:** 301 SOUTHRIDGE BLVD, SUITE A, HEBER SPRINGS, AR 72543-8875
- **Practice address phone:** (501) 362-0500
- **Practice address fax:** (501) 362-0501
- **Mailing address:** PO BOX 1678, HEBER SPRINGS, AR 72543-1678
- **Mailing address phone:** (501) 362-0500
- **Mailing address fax:** (501) 362-0501

## Taxonomy

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

## Other

- **Enumeration date:** 06/04/2006
- **Last updated:** 09/09/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 149835002 | — | AR |
| 01 | — | DA1227 | RAILROAD MEDICARE NUMBER | AR |