Organization
ASHDOWN MEDICAL CLINIC PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TONI TACKETT WOMBLE APRN (OWNER)
(870) 898-5037
Entity
Organization
Contact information
Practice address
418 N 2ND ST, ASHDOWN, AR 71822-2755
(870) 898-5037
(870) 898-3910
Mailing address
418 N 2ND ST, ASHDOWN, AR 71822-2755
(870) 898-5037
(870) 898-3910
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
A003233
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
199114762
—
AR
Enumeration date
08/13/2013
Last updated
01/27/2016
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