Organization
ABRAHAM MEDICAL CENTER, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
K SIMON S ABRAHAM MD (PRESIDENT)
(870) 425-6991
Entity
Organization
Contact information
Practice address
15 GREEN VALLEY DR, MOUNTAIN HOME, AR 72653-8102
(870) 425-6991
Mailing address
15 GREEN VALLEY DR, MOUNTAIN HOME, AR 72653-8102
(870) 425-6991
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101015002
—
AR
Enumeration date
12/08/2006
Last updated
01/06/2012
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