Organization
MONTICELLO MEDICAL CLINIC, PLC
Active
Parent organization
MONTICELLO MEDICAL CLINIC PLC
Other names
MMC-Star City Satellite Clinic
Organization subpart
Yes
Provider details
NPI number
Legal business name
MONTICELLO MEDICAL CLINIC PLC
Authorized official
SYLVIA SIMON M.D. (MEDICAL DIRECTOR)
(870) 367-6867
Entity
Organization
Contact information
Practice address
1306 N. LINCOLN AVENUE, STAR CITY, AR 71667
(870) 628-1388
(870) 628-1347
Mailing address
906 ROBERTS DR, MONTICELLO, AR 71655-5724
(870) 367-6867
(870) 367-1461
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MC-1891
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
139812002
—
AR
Enumeration date
05/04/2018
Last updated
05/04/2018
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