Organization
BAXTER REGIONAL HEALTH SYSTEM
Active
Other names
BRMC Hometown Clinic at Mammoth Spring
Organization subpart
No
Provider details
NPI number
Authorized official
LEONARD BERNARD LARRY (VICE PRESIDENT)
(870) 508-1011
Entity
Organization
Contact information
Practice address
277 MAIN STREET, MAMMOTH SPRING, AR 72554
(870) 269-3455
Mailing address
PO BOX 1288, MOUNTAIN VIEW, AR 72560-1288
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
12/30/2019
Last updated
12/30/2019
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