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General NPI Number Information
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NPI Number | 1851461859
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Entity Type | Organization
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Legal Business Name | PSYCHIATRIC CLINIC PA
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Dates
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Enumeration Date | 11/08/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2301 W MAIN ST
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City | RUSSELLVILLE
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State | AR
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Zip | 72801
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Country | US
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Telephone | 479-968-3329
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Fax | 479-968-2848
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Provider Business Mailing Address
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Address Line | 2301 W MAIN ST
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City | RUSSELLVILLE
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State | AR
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Zip | 72801
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Country | US
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Telephone | 479-968-3329
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Fax | 479-968-2848
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. LINDA O BELL
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Credential | MD
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Telephone | 479-968-3323
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | C4067
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License Number State | AR
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