Healthcare Provider Details

I. General information

NPI: 1467872747
Provider Name (Legal Business Name): EF CLINIC INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/24/2014
Last Update Date: 04/24/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

707 THIRD ST
HORSESHOE BEND AR
72512-3732
US

IV. Provider business mailing address

600 MARKET ST
HORSESHOE BEND AR
72512-3876
US

V. Phone/Fax

Practice location:
  • Phone: 870-670-4580
  • Fax:
Mailing address:
  • Phone: 870-670-4580
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberE-2759
License Number StateAR

VIII. Authorized Official

Name: FRANK FOWLER
Title or Position: PRESIDENT
Credential:
Phone: 870-670-4580