Organization
IRVIN & DIBRELL MEDICAL CLINIC, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN D IRVIN M.D. (PRESIDENT)
(870) 269-9800
Entity
Organization
Contact information
Practice address
803 WEST MAIN, MOUNTAIN VIEW, AR 72560
(870) 269-9800
(870) 269-9614
Mailing address
P. O. BOX 106, MOUNTAIN VIEW, AR 72560
(870) 269-9800
(870) 269-9614
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5C651
BLUE CROSS BLUE SHIELD
AR
01
—
DB3125
RAILROAD MEDICARE
AR
Enumeration date
07/20/2006
Last updated
06/24/2010
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