Healthcare Provider Details

I. General information

NPI: 1316145022
Provider Name (Legal Business Name): THE KIRKLAND FAMILY MEDICAL CENTER, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/03/2007
Last Update Date: 02/13/2024
Certification Date: 02/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1652 STATE HIGHWAY 22 W
DARDANELLE AR
72834-2909
US

IV. Provider business mailing address

1652 STATE HIGHWAY 22 W
DARDANELLE AR
72834-2909
US

V. Phone/Fax

Practice location:
  • Phone: 479-229-8000
  • Fax: 479-477-3925
Mailing address:
  • Phone: 479-229-8000
  • Fax: 833-637-1613

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code305R00000X
TaxonomyPreferred Provider Organization
License NumberE0985
License Number StateAR

VIII. Authorized Official

Name: DR. ALLAN KARL KIRKLAND
Title or Position: PRESIDENT
Credential: M.D.
Phone: 479-229-8000