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General NPI Number Information
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NPI Number | 1689679169
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Entity Type | Organization
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Legal Business Name | PHYSICIANS NETWORK INC.
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Dates
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Enumeration Date | 06/20/2005
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 1300 BRADEN ST
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City | JACKSONVILLE
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State | AR
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Zip | 72076-3719
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Country | US
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Telephone | 501-985-5900
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Fax | 501-985-6016
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Provider Business Mailing Address
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Address Line | PO BOX 309
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City | JACKSONVILLE
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State | AR
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Zip | 72078-0309
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Country | US
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Telephone | 501-985-5900
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Fax | 501-985-6016
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. JULIAN DALE CALHOON
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Credential | M.D.
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Telephone | 501-985-5900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State | AR
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Taxonomy #2
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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 | AR
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