MEDICARE: LEE COUNTY COOPERATIVE CLINIC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QD0000X	Dental Clinic/Center

General Provider Information

NPI Number	:	1700034998
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LEE COUNTY COOPERATIVE CLINIC

Provider Business Mailing Address
First Line	:	PO BOX 669
Second Line	:
City	:	MARIANNA
State	:	AR
Zip	:	72360-0669
Country	:	US
Telephone Number	:	870-295-5225
Fax Number	:

Provider Business Practice Location Address
First Line	:	530 ATKINS BLVD
Second Line	:
City	:	MARIANNA
State	:	AR
Zip	:	72360-2113
Country	:	US
Telephone Number	:	870-295-5225
Fax Number	:

Authorized Official
Title or Position	:	BILLING CLERK
Name	:	OSSIE M M HALL
Credential	:
Telephone Number	:	870-295-5225

Provider Enumeration Date	:	09/03/2008
Last Update Date	:	03/02/2021

Similar Medicare Providers

1669480836 — LEE COUNTY COOPERATIVE CLINIC
Practice Location Address:

530 WEST ATKINS BLVD
MARIANNA, AR
72360-2113

Practice Phone: 870-295-5225
Practice Fax: 870-295-6900

1851403422 — THOMAS O BAILEY MD
Practice Location Address:

558 ATKINS BLVD
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72360-2113

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Practice Fax:

1851433858 — LEE COUNTY COOPERATIVE CLINIC
Practice Location Address:

530 ATKINS BLVD
MARIANNA, AR
72360-2113

Practice Phone: 870-295-5225
Practice Fax: 870-295-6900

1346430980 — DR. LINDA F COLLINS M.D.
Practice Location Address:

530 ATKINS BLVD
MARIANNA, AR
72360-2113

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Practice Fax: 870-295-6900

1245491380 — DR. HARRY ANDRE MICHEL M.D.
Practice Location Address:

530 ATKINS BLVD
MARIANNA, AR
72360-2113

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1235465303 — YEE L YANG DMD
Practice Location Address:

530 ATKINS BLVD
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Practice Fax: 870-295-6900

Directions to “LEE COUNTY COOPERATIVE CLINIC ” Practice Location

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