Organization
CONWAY CHILDRENS CLINIC PA CORP
Active
Other names
Greenbrier Childrens Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL CONNAUGHTON MD (OWNER/MD)
(501) 327-6000
Entity
Organization
Contact information
Practice address
10 LOIS LANE, GREENBRIER, AR 72058
(501) 679-6796
Mailing address
10 LOIS LANE, GREENBRIER, AR 72058
(501) 679-6796
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
043872
CMS#
—
Enumeration date
02/14/2012
Last updated
02/14/2012
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