Healthcare Provider Details

I. General information

NPI: 1770447948
Provider Name (Legal Business Name): PRIMARY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/12/2025
Last Update Date: 12/12/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

410 S CHURCH ST STE A
JONESBORO AR
72401-2947
US

IV. Provider business mailing address

304 S MAIN ST APT C
JONESBORO AR
72401-2999
US

V. Phone/Fax

Practice location:
  • Phone: 870-259-5794
  • Fax: 870-454-8356
Mailing address:
  • Phone: 870-259-5794
  • Fax: 870-454-8356

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: LEISA SPENCE
Title or Position: OWNER
Credential: MD
Phone: 954-610-6944