Organization
SALEM FAMILY CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL N MOODY (MEDICAL DOCTOR)
(870) 895-2541
Entity
Organization
Contact information
Practice address
507 N MAIN ST, SALEM, AR 72576-9449
(870) 895-2541
(870) 895-2957
Mailing address
PO BOX 829, SALEM, AR 72576-0829
(870) 895-2541
(870) 895-2957
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
MC0433
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102260002
—
AR
Enumeration date
02/27/2006
Last updated
12/22/2010
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