Organization
REGIONAL FAMILY MEDICINE PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN GREGORY ELDERS MD (CEO)
(870) 425-6971
Entity
Organization
Contact information
Practice address
630 BURNETT DR, MOUNTAIN HOME, AR 72653-2941
(870) 425-6971
(870) 508-8900
Mailing address
630 BURNETT DR, MOUNTAIN HOME, AR 72653-2941
(870) 425-6971
(870) 508-8900
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
121500001
—
AR
01
—
5F307
MEDICARE PTAN
AR
Enumeration date
07/08/2005
Last updated
07/21/2022
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