Organization
CACHE RIVER MEDICAL CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER TAYLOR (BILLING MANAGER)
(870) 588-7867
Entity
Organization
Contact information
Practice address
115 W KIMBERLY DRIVE, MCCRORY, AR 72101
(870) 731-0640
Mailing address
115 W KIMBERLY DRIVE, MCCRORY, AR 72101-8539
(870) 731-0640
(870) 731-0655
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C-7761
OWNERS MEDICAL LICENSE
AR
Enumeration date
05/11/2021
Last updated
07/14/2021
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