Organization
LEACHVILLE PRIMARY CARE CLINIC, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN S JOHNSON M.D. (OWNER)
(870) 539-1115
Entity
Organization
Contact information
Practice address
111 S MAIN ST, LEACHVILLE, AR 72438-0580
(870) 539-1115
(870) 539-1125
Mailing address
PO BOX 580, 111 S MAIN ST, LEACHVILLE, AR 72438-0580
(870) 539-1115
(870) 539-1125
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
C8443
AR
Other
Enumeration date
10/06/2005
Last updated
03/08/2012
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