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General NPI Number Information
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NPI Number | 1144609751
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Entity Type | Organization
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Legal Business Name | WRMC INTERNAL MEDICINE CLINIC
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Dates
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Enumeration Date | 05/28/2015
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Last Update Date | 10/15/2025
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Provider Practice Location Address
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Address Line | 3443 HARRISON ST
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City | BATESVILLE
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State | AR
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Zip | 72501-8820
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Country | US
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Telephone | 870-262-1510
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Fax | 870-262-1516
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Provider Business Mailing Address
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Address Line | 1710 HARRISON ST
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City | BATESVILLE
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State | AR
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Zip | 72501-7303
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Country | US
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Telephone | 870-262-1510
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Fax | 870-262-1516
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Authorized Official
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Title or Position | PROVIDER ENROLLMENT SPECIALIST
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Name | SHAWNA BAXTER
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Credential |
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Telephone | 870-262-1510
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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