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General NPI Number Information
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NPI Number | 1912853896
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Entity Type | Organization
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Legal Business Name | CCMOUN HEALTH PLLC
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Dates
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Enumeration Date | 03/04/2026
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Last Update Date | 03/04/2026
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Provider Practice Location Address
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Address Line | 701 SOUTH ST # 100
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City | MOUNTAIN HOME
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State | AR
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Zip | 72653-4452
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Country | US
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Telephone | 509-768-2249
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Fax | 248-780-3452
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Provider Business Mailing Address
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Address Line | 5904 SW COYWOLF ST
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City | BENTONVILLE
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State | AR
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Zip | 72713-3324
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Country | US
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Telephone |
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Fax | 248-780-3452
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Authorized Official
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Title or Position | MANAGER
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Name | DR. UZOMA MELISSA OBI-NWANKWO
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Credential |
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Telephone | 936-333-8090
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QG0300X
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Taxonomy Name | Geriatric Medicine (Family Medicine) Physician
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License Number |
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License Number State |
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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 |
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