Organization
MEDICAL CENTER CLINIC OF IZARD COUNTY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DONALD O. WRIGHT M.D. (CHIEF OF STAFF)
(870) 297-2475
Entity
Organization
Contact information
Practice address
35 GRASSE STREET, CALICO ROCK, AR 72519
(870) 297-2475
(870) 297-4380
Mailing address
PO BOX 819, CALICO ROCK, AR 72519-0819
(870) 297-2475
(870) 297-4380
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
—
—
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
208600000X
Surgery Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
137324002
—
AR
01
—
5C216
BLUE CROSS BLUE SHIELD
—
01
—
93492
HEALTH PARTNERS
—
Enumeration date
02/28/2006
Last updated
04/03/2012
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