Organization
COLLOM & CARNEY CLINIC
Active
Parent organization
COLLOM & CARNEY CLINIC
Other names
Collom and Carney Clinic Prescott Clinic
Organization subpart
Yes
Provider details
NPI number
Legal business name
COLLOM & CARNEY CLINIC
Authorized official
MARY E DWIGHT CCS-P, MHA, CMPE (CHIEF OPERATING OFFICER)
(903) 614-3282
Entity
Organization
Contact information
Practice address
1440 W 1ST N, PRESCOTT, AR 71853
(870) 887-8001
Mailing address
5002 COWHORN CREEK RD, TEXARKANA, TX 75503-9766
(903) 614-3000
(903) 614-3525
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
149724002
—
AR
01
—
CC9231
RAILROAD MEDICARE
—
Enumeration date
11/16/2005
Last updated
02/24/2023
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