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General NPI Number Information
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NPI Number | 1497996888
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Entity Type | Organization
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Legal Business Name | DR. ANDY'S FAMILY PRACTICE , PLLC
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Dates
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Enumeration Date | 03/13/2009
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Last Update Date | 10/07/2011
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Provider Practice Location Address
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Address Line | 1809 OZARKA COLLEGE DRIVE
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City | MOUNTAIN VIEW
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State | AR
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Zip | 72560
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Country | US
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Telephone | 870-269-7777
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1198
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City | MOUNTAIN VIEW
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State | AR
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Zip | 72560-1198
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Country | US
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Telephone | 870-269-7777
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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. VASUGIE ANANDARAJ
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Credential |
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Telephone | 870-269-7777
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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