Organization
MISENHEIMER MEDICAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. AMBROSIA ALEXANDRA MISENHEIMER FNP-C (OWNER/PRESIDENT)
(870) 918-6684
Entity
Organization
Contact information
Practice address
117 OAKHURST BLVD, EL DORADO, AR 71730-3736
(870) 918-6684
Mailing address
117 OAKHURST BLVD, EL DORADO, AR 71730-3736
(870) 918-6684
Taxonomy
Speciality
Code
Description
License number
State
261QE0002X
Emergency Care Clinic/Center
Primary
A004788
AR
Other
Enumeration date
06/21/2016
Last updated
06/21/2016
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