# MOUNTAIN VIEW CLINIC I LLC

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

## Provider details

- **NPI number:** 1851366777
- **Authorized official:** DR. RICHARD MARK LOCHALA M.D. (OWNER)
- **Authorized official phone:** (479) 394-7301

## Contact information

- **Practice address:** 1102 CRESTWOOD CIR, MENA, AR 71953-5513
- **Practice address phone:** (479) 394-7301
- **Practice address fax:** (479) 394-7160
- **Mailing address:** 1102 CRESTWOOD CIR, MENA, AR 71953-5513
- **Mailing address phone:** (479) 394-7301
- **Mailing address fax:** (479) 394-7160

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 2080A0000X | Pediatric Adolescent Medicine Physician | — | NULL | — |
| 2080A0000X | Pediatric Adolescent Medicine Physician | — | — | — |
| 363A00000X | Physician Assistant | — | NULL | — |
| 363A00000X | Physician Assistant | — | — | — |

## Other

- **Enumeration date:** 02/22/2006
- **Last updated:** 10/06/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 135991002 | — | AR |
| 01 | — | 5B765 | BCBS CLINIC \# | AR |