Organization
AMMC PHYSICIAN SERVICES, INC.
Active
Other names
Paragould Urology
Organization subpart
No
Provider details
NPI number
Authorized official
BRYAN JACKSON (CFO)
(870) 239-7102
Entity
Organization
Contact information
Practice address
1000 W KINGSHIGHWAY, PARAGOULD, AR 72450-4141
(870) 236-3308
Mailing address
1000 W KINGSHIGHWAY, PARAGOULD, AR 72450-4141
(870) 236-3308
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
—
Other
Enumeration date
12/03/2010
Last updated
12/03/2010
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