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General NPI Number Information
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NPI Number | 1538296256
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Entity Type | Organization
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Legal Business Name | THRONEBERRY FAMILY CLINIC, P.A.
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Dates
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Enumeration Date | 02/28/2007
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Last Update Date | 05/04/2021
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Provider Practice Location Address
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Address Line | 2869 COLLEGE AVE
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City | CONWAY
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State | AR
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Zip | 72034-6087
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Country | US
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Telephone | 501-327-2611
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Fax | 501-336-9763
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Provider Business Mailing Address
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Address Line | 2869 COLLEGE AVE
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City | CONWAY
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State | AR
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Zip | 72034-6087
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Country | US
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Telephone | 501-327-2611
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Fax | 501-336-9763
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Authorized Official
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Title or Position | OWNER
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Name | DR. JAMES BARTON THRONEBERRY
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Credential | MD
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Telephone | 501-327-2611
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | MC1741
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License Number State | AR
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