Organization
RICH MOUNTAIN WOMENS CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN D. MESKO M.D. (DOCTOR)
(479) 394-4595
Entity
Organization
Contact information
Practice address
403 MORROW ST N STE A, MENA, AR 71953-4324
(479) 394-4595
(479) 394-1140
Mailing address
403 MORROW ST N STE A, MENA, AR 71953-4324
(479) 394-4595
(479) 394-1140
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
C-6220
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10071960 A
—
OK
05
—
112972001
—
AR
01
—
50764
BLUE CROSS BLUE SHEILD
AR
Enumeration date
02/16/2009
Last updated
02/16/2009
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