Organization
DR. ANDY'S FAMILY PRACTICE , PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. VASUGIE ANANDARAJ (OFFICE MANAGER)
(870) 269-7777
Entity
Organization
Contact information
Practice address
1809 OZARKA COLLEGE DRIVE, MOUNTAIN VIEW, AR 72560
(870) 269-7777
Mailing address
PO BOX 1198, MOUNTAIN VIEW, AR 72560-1198
(870) 269-7777
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
161503001
—
AR
Enumeration date
03/13/2009
Last updated
10/07/2011
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