Organization
MOUNTAIN-HOME MEDICAL GROUP, PA
Active
Other names
Mtn Home Medical Group PA
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MAXWELL G CHENEY MD (OWNER)
(870) 425-3125
Entity
Organization
Contact information
Practice address
353 EAST 8TH STREET, MOUNTAIN HOME, AR 72653
(870) 425-3125
(870) 424-5059
Mailing address
PO BOX 1836, MOUNTAIN HOME, AR 72654-1836
(870) 425-3125
(870) 424-5059
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
MC0049
AR
207R00000X
Internal Medicine Physician
Primary
MC0049
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101002002
—
AR
Enumeration date
05/08/2006
Last updated
04/14/2011
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