Healthcare Provider Details

I. General information

NPI: 1912158619
Provider Name (Legal Business Name): MEDI-QUICK WALK-IN CLINIC, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/01/2008
Last Update Date: 10/01/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10144 HIGHWAY 63 NORTH SUITE A
BONO AR
72416
US

IV. Provider business mailing address

PO BOX 119
BONO AR
72416-0119
US

V. Phone/Fax

Practice location:
  • Phone: 870-932-8600
  • Fax: 870-932-8601
Mailing address:
  • Phone: 870-932-8600
  • Fax: 870-932-8601

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License NumberE-4047
License Number StateAR
# 2
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License NumberE-4046
License Number StateAR

VIII. Authorized Official

Name: DR. ANTHONY SLOAN
Title or Position: DOCTOR OF MEDICINE
Credential:
Phone: 870-932-5740