Healthcare Provider Details

I. General information

NPI: 1508162496
Provider Name (Legal Business Name): NATIONAL PARK FAMILY CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/10/2011
Last Update Date: 02/09/2023
Certification Date: 02/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

124 HOLLYWOOD AVE
HOT SPRINGS AR
71901-7057
US

IV. Provider business mailing address

PO BOX 4811
BELFAST ME
04915-4811
US

V. Phone/Fax

Practice location:
  • Phone: 501-624-0070
  • Fax: 501-624-8721
Mailing address:
  • Phone: 501-624-0070
  • Fax: 501-624-8721

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMC1391
License Number StateAR

VIII. Authorized Official

Name: MONICA BOWMAN
Title or Position: PRESIDENT
Credential:
Phone: 615-920-7000