Organization
RUSSELLVILLE WOMEN'S CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOE CLOUD M.D. (CO-OWNER)
(479) 968-1011
Entity
Organization
Contact information
Practice address
200 N QUANAH AVE, RUSSELLVILLE, AR 72801-2762
(479) 968-1011
Mailing address
200 N QUANAH AVE, RUSSELLVILLE, AR 72801-2762
(479) 968-1011
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
57692
ARK BLUECROSS
AR
Enumeration date
03/21/2006
Last updated
08/22/2020
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