Forrest City Family Practice Clinic, PA
Family Medicine, Adult Medicine in Forrest City, AR. Organization (NPI-2).
NPI number1649396979
StatusActive
Last updated in NPPESDec 1, 2011
Details
- NPI
- 1649396979
- Entity type
- Organization (NPI-2)
- Legal business name
- Forrest City Family Practice Clinic, PA
- Organization subpart
- No
- Enumeration date
- Mar 21, 2007
- Last updated
- Dec 1, 2011
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207QA0505X | Family Medicine, Adult Medicine | R3762 | AR | Yes |
| 207QA0000X | Family Medicine, Adolescent Medicine | R3762 | AR | |
| 207QG0300X | Family Medicine, Geriatric Medicine | R3762 | AR |
Practice location
902 Holiday DrSuite 101
Forrest City, AR 72335-9183
Phone 870-630-1256
Mailing address
902 Holiday DrSuite 101
Forrest City, AR 72335-9183
Phone 870-630-1256
Authorized official
Neida Byrd
Billing Manager
9017373071
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