Organization
RUSSELLVILLE GYNECOLOGY CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LAWRENCE DOUGLAS BATTLES M.D. (PRESIDENT)
(479) 968-7909
Entity
Organization
Contact information
Practice address
914 W B ST, RUSSELLVILLE, AR 72801-3502
(479) 968-7909
(479) 968-6908
Mailing address
914 W B ST, RUSSELLVILLE, AR 72801-3502
(479) 968-7909
(479) 968-6908
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
C4687
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0004567368
AETNA NUMBER
AR
01
—
13403000000
QUALCHOICE NUMBER
AR
01
—
7420060
UNITED HEALTHCARE NUMBER
AR
Enumeration date
10/28/2005
Last updated
08/22/2020
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