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General NPI Number Information
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NPI Number | 1376684183
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Entity Type | Organization
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Legal Business Name | HENDRIX MEDICAL SERVICES, P.L.L.C.
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Dates
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Enumeration Date | 02/12/2007
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Last Update Date | 11/14/2007
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Provider Practice Location Address
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Address Line | 2709 W KINGSHIGHWAY SUITE 8
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City | PARAGOULD
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State | AR
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Zip | 72450-4141
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Country | US
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Telephone | 870-236-3388
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Fax | 870-236-2656
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Provider Business Mailing Address
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Address Line | 2709 W KINGSHIGHWAY SUITE 8
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City | PARAGOULD
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State | AR
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Zip | 72450-4141
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Country | US
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Telephone | 870-236-3388
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Fax | 870-236-2656
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. LISA MICHELLE HENDRIX
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Credential | M.D.
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Telephone | 870-236-3388
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207K00000X
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Taxonomy Name | Allergy & Immunology Physician
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License Number | E-0966
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License Number State | AR
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