Healthcare Provider Details

I. General information

NPI: 1639698558
Provider Name (Legal Business Name): ACCESS MEDICAL CLINIC ARKANSAS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/12/2017
Last Update Date: 09/19/2025
Certification Date: 02/03/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

217 N MAIN ST
RISON AR
71665
US

IV. Provider business mailing address

49 HIGHWAY 62 412
ASH FLAT AR
72513-9594
US

V. Phone/Fax

Practice location:
  • Phone: 888-264-5034
  • Fax: 870-895-2164
Mailing address:
  • Phone: 888-264-5034
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: BRADLEY RAY BIBB
Title or Position: CEO
Credential: MD
Phone: 870-994-7301