Organization
ARKANSAS FAMILY CARE NETWORK
Active
Other names
RUSSELLVILLE PEDIATRIC & ADOLESCENT CLINIC
Organization subpart
No
Provider details
NPI number
Authorized official
JEFF ERWIN (CEO)
(501) 224-1690
Entity
Organization
Contact information
Practice address
220 N SIDNEY AVE, RUSSELLVILLE, AR 72801-4389
(479) 498-0858
(479) 498-0809
Mailing address
220 N SIDNEY AVE, RUSSELLVILLE, AR 72801-4389
(479) 498-0858
(479) 498-0809
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
213751002
—
AR
Enumeration date
10/18/2017
Last updated
10/18/2017
Update your record
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