Healthcare Provider Details

I. General information

NPI: 1144312299
Provider Name (Legal Business Name): MORRILTON MEDICAL CLINIC, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/28/2006
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

#10 HOSPITAL DRIVE
MORRILTON AR
72110
US

IV. Provider business mailing address

10 HOSPITAL DR
MORRILTON AR
72110-4510
US

V. Phone/Fax

Practice location:
  • Phone: 501-354-0052
  • Fax: 501-354-9142
Mailing address:
  • Phone: 501-354-0052
  • Fax: 501-354-9142

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: MATTHEW STENGEL
Title or Position: ADMINISTRATOR
Credential:
Phone: 501-354-0052