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Organization

GRAND PRAIRIE MEDICAL GROUP, PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
CANDICE SMITH (BILLING SUPERVISOR)
(903) 791-9355
Entity
Organization

Contact information

Practice address
1012 E 22ND ST, STUTTGART, AR 72160-6825
(870) 672-0911
(870) 672-0914
Mailing address
1012 E 22ND ST, STUTTGART, AR 72160-6825
(870) 672-0911
(870) 672-0914

Taxonomy

Speciality
Code
Description
License number
State
261QU0200X
Urgent Care Clinic/Center
Primary

Other

Enumeration date
06/04/2014
Last updated
11/14/2014
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