Organization
MIMO MEDICAL SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MATHIAS GROGUHE (MANAGING EMPLOYEE)
(512) 201-6766
Entity
Organization
Contact information
Practice address
2506 CRESTVIEW DR, MAGNOLIA, AR 71753-4336
(479) 530-1308
(479) 968-1673
Mailing address
PO BOX 9178, RUSSELLVILLE, AR 72811-9178
(800) 824-4094
(479) 968-1673
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
09/02/2020
Last updated
02/25/2026
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