Healthcare Provider Details

I. General information

NPI: 1669319489
Provider Name (Legal Business Name): PHILLIPS FAMILY HEALTHCARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/30/2026
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

98 HIGHWAY 63B
MARKED TREE AR
72365-1600
US

IV. Provider business mailing address

2921 HWY 77 S STE 12-13
MARION AR
72364-2314
US

V. Phone/Fax

Practice location:
  • Phone: 870-559-4252
  • Fax: 870-559-4253
Mailing address:
  • Phone: 870-559-4252
  • Fax: 870-559-4253

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: TEDDY W PHILLIPS
Title or Position: OWNER
Credential: APRN, FNP-BC
Phone: 870-559-4252