Organization
MENA HEART AND VASCULAR CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BOB ELLZEY (CEO)
(479) 394-6100
Entity
Organization
Contact information
Practice address
403 MORROW ST N, SUITE G, MENA, AR 71953-4324
(479) 394-6100
Mailing address
PO BOX 295, LOCKESBURG, AR 71846-0295
(870) 289-5865
(870) 289-6993
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
E5746
AR
Other
Enumeration date
06/22/2009
Last updated
06/22/2009
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