Healthcare Provider Details

I. General information

NPI: 1053192401
Provider Name (Legal Business Name): PHILLIPS CLINIC COMPANY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/11/2023
Last Update Date: 06/17/2025
Certification Date: 06/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1803 MARTIN LUTHER KING JR DR STE A
HELENA AR
72342-9103
US

IV. Provider business mailing address

1801 MARTIN LUTHER KING JR DR
HELENA AR
72342-8998
US

V. Phone/Fax

Practice location:
  • Phone: 870-338-7441
  • Fax: 870-338-7945
Mailing address:
  • Phone: 870-816-3900
  • Fax: 870-816-3909

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: LAURA J FEY
Title or Position: SR DIRECTOR PHYSICIAN PRACTICE
Credential:
Phone: 615-221-3641