Organization
SOUTHSIDE MEDICAL CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THUYLINH PHAM MD (CEO)
(870) 424-5079
Entity
Organization
Contact information
Practice address
623 S 21ST ST, FORT SMITH, AR 72901-3914
(479) 441-1500
(479) 441-1502
Mailing address
PO BOX 310, MOUNTAIN HOME, AR 72654-0310
(870) 424-0899
(870) 424-8455
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
E1751
AR
Other
Enumeration date
05/03/2007
Last updated
08/22/2020
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