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General NPI Number Information
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NPI Number | 1366831448
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Entity Type | Organization
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Legal Business Name | FAMILY FIRST PRIMARY CARE, PA
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Dates
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Enumeration Date | 01/13/2015
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Last Update Date | 01/13/2015
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Provider Practice Location Address
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Address Line | 25 BUSINESS PARK DR
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City | GREENBRIER
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State | AR
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Zip | 72058
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Country | US
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Telephone | 501-679-3998
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 177
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City | GREENBRIER
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State | AR
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Zip | 72058-0177
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Country | US
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Telephone | 501-679-3998
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. RAINEY BART
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Credential |
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Telephone | 501-679-3998
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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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