Organization
COMMUNITY PHYSICIANS GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIM BOWEN (CEO)
(870) 289-5865
Entity
Organization
Contact information
Practice address
311 MORROW ST N, MENA, AR 71953-2516
(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
2085B0100X
Body Imaging Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
150034002
—
AR
05
—
200082550A
—
OK
05
—
770304502
—
AR
Enumeration date
05/20/2006
Last updated
11/25/2013
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