Organization
MISSISSIPPI COUNTY PRIMARY CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TONYA M MALADY (BILLING)
(901) 737-3071
Entity
Organization
Contact information
Practice address
602 W UNION AVE STE B, OSCEOLA, AR 72370-3014
(901) 737-3071
Mailing address
602 W UNION AVE STE B, OSCEOLA, AR 72370-3014
(901) 737-3071
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
E3411
AR
Other
Enumeration date
04/06/2007
Last updated
08/22/2020
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