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Organization
MAIN STREET MEDICAL CLINIC, P.A.
Active
Organization
MAIN STREET MEDICAL CLINIC, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHERYL WILCHMAN (OFFICE MANAGER)
(501) 315-0059
Entity
Organization
Contact information
Practice address
722 N MAIN ST, BENTON, AR 72015-3337
(501) 315-0059
(501) 315-1320
Mailing address
722 N MAIN ST, BENTON, AR 72015-3337
(501) 315-0059
(501) 315-1320
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MC-2252
AR
208000000X
Pediatrics Physician
MC-2252
AR
Other
Enumeration date
07/13/2005
Last updated
05/20/2021
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