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General NPI Number Information
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NPI Number | 1477001865
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Entity Type | Organization
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Legal Business Name | EAST ARKANSAS FAMILY HEALTH CENTER
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Dates
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Enumeration Date | 09/14/2016
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Last Update Date | 11/18/2020
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Provider Practice Location Address
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Address Line | 513 PORTER ST
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City | HELENA
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State | AR
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Zip | 72342-3217
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Country | US
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Telephone | 870-817-0122
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Fax |
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Provider Business Mailing Address
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Address Line | 900 N 7TH ST
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City | WEST MEMPHIS
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State | AR
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Zip | 72301-2001
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Country | US
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Telephone | 870-735-3842
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | SUSAN WARD-JONES
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Credential | M.D.
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Telephone | 870-817-0122
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305R00000X
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Taxonomy Name | Preferred Provider Organization
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License Number |
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License Number State |
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