Healthcare Provider Details

I. General information

NPI: 1740259217
Provider Name (Legal Business Name): CARAWAY MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/16/2006
Last Update Date: 09/12/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2929 S CARAWAY RD STE 1
JONESBORO AR
72401-7307
US

IV. Provider business mailing address

2929 S CARAWAY RD STE 1
JONESBORO AR
72401-7307
US

V. Phone/Fax

Practice location:
  • Phone: 870-268-9400
  • Fax: 870-268-9420
Mailing address:
  • Phone: 870-268-9400
  • Fax: 870-268-9420

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberC5299
License Number StateAR

VIII. Authorized Official

Name: DR. JOSEPH B PIERCE
Title or Position: ADMINISTRATOR/OWNER
Credential: M.D.
Phone: 870-268-9400