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Organization

ARKANSAS CENTRAL PRIMARY CARE, PLLC

Active
Other names
Jacksonville Medical Care
Organization subpart
No

Provider details

NPI number
Authorized official
MR. GARY DREW JACKSON (CLINIC ADMINISTRATOR)
(501) 985-5994
Entity
Organization

Contact information

Practice address
1300 BRADEN ST., JACKSONVILLE, AR 72076-3719
(501) 985-5900
(501) 985-6016
Mailing address
PO BOX 309, JACKSONVILLE, AR 72078-0309
(501) 985-5900
(501) 985-6016

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
208D00000X
General Practice Physician

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
142734002
AR
05
176116002
AR
Enumeration date
10/03/2008
Last updated
02/02/2011
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