Organization
MISSION CLINICAL SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK LAREY D.O. (EXECUTIVE DIRECTOR)
(501) 622-1085
Entity
Organization
Contact information
Practice address
1 MERCY LN, SUITE 405, HOT SPRINGS, AR 71913-6442
(501) 622-1939
(501) 622-3993
Mailing address
1 MERCY LN, SUITE 405, HOT SPRINGS, AR 71913-6442
(501) 622-1939
(501) 622-3993
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
152397002
—
AR
01
—
5C837
AR BCBS PROV #
AR
Enumeration date
03/03/2006
Last updated
09/18/2008
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