Phomakay Primary Care PA
Family Medicine in Barling, AR. Organization (NPI-2).
NPI number1124466701
StatusActive
Last updated in NPPESNov 27, 2013
Details
- NPI
- 1124466701
- Entity type
- Organization (NPI-2)
- Legal business name
- Phomakay Primary Care PA
- Organization subpart
- No
- Enumeration date
- Jun 5, 2013
- Last updated
- Nov 27, 2013
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | E-6214 | AR | Yes |
Practice location
10301 Mayo DrBarling, AR 72923-1660
Phone 479-782-5500 · Fax 479-782-5502
Mailing address
Po Box 10154Fort Smith, AR 72917-0154
Phone 479-782-5500 · Fax 479-782-5502
Authorized official
Chansamone M Phomakay
Owner
4797825500
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