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Organization
MOUNTAIN VIEW CLINIC I LLC
Active
Organization
MOUNTAIN VIEW CLINIC I LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD MARK LOCHALA M.D. (OWNER)
(479) 394-7301
Entity
Organization
Contact information
Practice address
1102 CRESTWOOD CIR, MENA, AR 71953-5513
(479) 394-7301
(479) 394-7160
Mailing address
1102 CRESTWOOD CIR, MENA, AR 71953-5513
(479) 394-7301
(479) 394-7160
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
2080A0000X
Pediatric Adolescent Medicine Physician
—
NULL
2080A0000X
Pediatric Adolescent Medicine Physician
—
—
363A00000X
Physician Assistant
—
NULL
363A00000X
Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
135991002
—
AR
01
—
5B765
BCBS CLINIC #
AR
Enumeration date
02/22/2006
Last updated
10/06/2020
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