Organization
CONWAY REGIONAL MEDICAL CENTER, INC
Active
Other names
Conway Regional Medical Clinic-Russellville
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM PACK (CFO)
(501) 450-2112
Entity
Organization
Contact information
Practice address
108 SKYLINE DR, RUSSELLVILLE, AR 72801-3362
(479) 968-7170
(479) 968-7607
Mailing address
PO BOX 9662, CONWAY, AR 72033-9662
(501) 852-1363
(501) 852-1364
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
AR
Other
Enumeration date
05/03/2018
Last updated
11/09/2023
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