Organization
FORREST CITY CLINIC COMPANY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAURA J FEY (SR DIRECTOR PHYSICIAN PRACTICE REV)
(615) 221-3641
Entity
Organization
Contact information
Practice address
1601 NEWCASTLE ROAD, FORREST CITY, AR 72336
(870) 261-0000
Mailing address
1601 NEWCASTLE ROAD, FORREST CITY, AR 72336
(870) 261-0000
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
166132002
—
AR
01
—
5F850
BCBS
AR
Enumeration date
06/18/2007
Last updated
01/19/2022
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