Organization
FAMILY PRACTICE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. BRENDA LYNN SMITH (OFFICE MANAGER)
(501) 745-2800
Entity
Organization
Contact information
Practice address
194 SHAKERAG ROAD, CLINTON, AR 72031
(501) 745-2800
(501) 745-8864
Mailing address
PO BOX 1100, CLINTON, AR 72031-1100
(501) 745-2800
(501) 745-8864
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
N6056
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
106212001
—
AR
Enumeration date
08/05/2007
Last updated
09/23/2011
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