Individual
PHILIP C PACKARD
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
ACSW
Contact information
Practice address
715 N COLLEGE AVE, EL DORADO, AR 71730-4403
(870) 862-7921
(870) 864-2490
Mailing address
715 N COLLEGE AVE, EL DORADO, AR 71730-4403
(870) 862-7921
(870) 864-2490
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
210-C
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
040971
MANAGED HEALTH NETWORK
AR
01
—
281938
VALUE OPTIONS
AR
01
—
5S094
BLUE CROSS
AR
Enumeration date
03/14/2006
Last updated
07/08/2007
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