MEDICARE: MERCY CLINIC FORT SMITH COMMUNITIES

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	261QM1300X	Multi-Specialty Clinic/Center

General Provider Information

NPI Number	:	1902073620
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MERCY CLINIC FORT SMITH COMMUNITIES

Provider Business Mailing Address
First Line	:	2901 S 74TH ST
Second Line	:
City	:	FORT SMITH
State	:	AR
Zip	:	72903-5156
Country	:	US
Telephone Number	:	479-314-1101
Fax Number	:	479-314-4704

Provider Business Practice Location Address
First Line	:	2901 S 74TH ST
Second Line	:
City	:	FORT SMITH
State	:	AR
Zip	:	72903-5156
Country	:	US
Telephone Number	:	479-314-1101
Fax Number	:	479-314-4704

Authorized Official
Title or Position	:	CFO
Name	:	GRETA WILCHER JR.
Credential	:
Telephone Number	:	479-831-7464

Provider Enumeration Date	:	05/12/2008
Last Update Date	:	04/30/2025

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