Healthcare Provider Details

I. General information

NPI: 1376848978
Provider Name (Legal Business Name): FAMILY MEDICAL WALK-IN CLINIC PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/13/2011
Last Update Date: 06/06/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1310 W WALNUT ST SUITE F
ROGERS AR
72756-3316
US

IV. Provider business mailing address

4049 S CAMPBELL AVE
SPRINGFIELD MO
65807-5303
US

V. Phone/Fax

Practice location:
  • Phone: 855-707-5550
  • Fax:
Mailing address:
  • Phone: 417-890-5550
  • Fax: 417-889-6898

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. DANIEL J BURKE
Title or Position: OWNER/MEDICAL DIRECTOR
Credential: D.O.
Phone: 417-890-5550