Organization
PRESCOTT FAMILY CLINIC P A
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL CLARENCE YOUNG M.D. (PRESIDENT)
(870) 887-6651
Entity
Organization
Contact information
Practice address
301 HALE AVE, PRESCOTT, AR 71857-3330
(870) 887-6651
(870) 887-2008
Mailing address
301 HALE AVE, PRESCOTT, AR 71857-3330
(870) 887-6651
(870) 887-2008
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1831150747
—
AR
01
—
56900
BCBS
AR
01
—
DG5104
GBA RAILROAD
AR
Enumeration date
03/30/2006
Last updated
09/09/2013
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