Organization
SAINT MARYS PRIMARY CARE NETWORK LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY J. TEAGUE (SECRETARY)
(615) 920-7000
Entity
Organization
Contact information
Practice address
1600 W C PL, RUSSELLVILLE, AR 72801-2705
(479) 967-7717
(866) 280-8464
Mailing address
1600 W C PL, RUSSELLVILLE, AR 72801-2705
(479) 967-7717
(866) 280-8464
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
—
—
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
09/26/2018
Last updated
12/12/2019
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