Healthcare Provider Details

I. General information

NPI: 1083678437
Provider Name (Legal Business Name): MCGEHEE FAMILY CLINIC PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/13/2006
Last Update Date: 04/09/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 HOLLY ST
MC GEHEE AR
71654-2108
US

IV. Provider business mailing address

601 HOLLY ST
MC GEHEE AR
71654-2108
US

V. Phone/Fax

Practice location:
  • Phone: 870-222-6131
  • Fax: 870-222-5909
Mailing address:
  • Phone: 870-222-6131
  • Fax: 870-222-5909

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License NumberMC-0302
License Number StateAR

VIII. Authorized Official

Name: DR. JAMES E. YOUNG
Title or Position: M.D.
Credential:
Phone: 870-222-6131