Organization
CHARLES ROY KLEPPER ET AL PTRS
Active
Other names
Main Street Medical Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES R. KLEPPER M.D. (OWNER)
(870) 741-3592
Entity
Organization
Contact information
Practice address
707 N MAIN ST, HARRISON, AR 72601-2912
(870) 741-3592
(870) 741-7733
Mailing address
707 N MAIN ST, HARRISON, AR 72601-2912
(870) 741-3592
(870) 741-7733
Taxonomy
Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
127780002
—
AR
01
—
5B704
ARK. BLUE SHIELD
AR
Enumeration date
08/20/2006
Last updated
04/30/2014
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