Organization
ST MARYS PHYSICIAN SERVICES LLC
Active
Other names
Millard-Henry Obstetrics/Gynecology and General Surgery Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLOTTE LAWRENCE (SECRETARY)
(615) 920-7000
Entity
Organization
Contact information
Practice address
105 SKYLINE DR, RUSSELLVILLE, AR 72801-3363
(479) 968-2345
(479) 890-7139
Mailing address
330 SEVEN SPRINGS WAY, BRENTWOOD, TN 37027-5098
(615) 920-7000
(615) 920-8775
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Enumeration date
07/19/2025
Last updated
08/25/2025
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