Healthcare Provider Details

I. General information

NPI: 1487970273
Provider Name (Legal Business Name): ARKANSAS QUICK CARE, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/19/2010
Last Update Date: 07/12/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 N JAMES ST
JACKSONVILLE AR
72076-3119
US

IV. Provider business mailing address

1101 N JAMES ST
JACKSONVILLE AR
72076-3119
US

V. Phone/Fax

Practice location:
  • Phone: 501-241-1919
  • Fax:
Mailing address:
  • Phone: 501-241-1919
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License NumberE-5482
License Number StateAR
# 2
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number StateAR

VIII. Authorized Official

Name: DR. TERRY D PEERY
Title or Position: CEO
Credential: M.D.
Phone: 501-241-1919