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General NPI Number Information
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NPI Number | 1942337282
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Entity Type | Organization
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Legal Business Name | LAWRENCE COUNTY FAMILY CLINIC, PA
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Dates
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Enumeration Date | 02/27/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1210 W MAIN ST
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City | WALNUT RIDGE
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State | AR
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Zip | 72476-1005
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Country | US
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Telephone | 870-886-3543
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Fax | 870-886-3252
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Provider Business Mailing Address
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Address Line | PO BOX 719
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City | WALNUT RIDGE
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State | AR
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Zip | 72476-0719
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Country | US
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Telephone | 870-886-3543
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Fax | 870-886-3252
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MS. KAREN PATTERSON
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Credential |
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Telephone | 870-886-3543
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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