institution
Russellville Gynecology Clinic
Gynecology Physician in Russellville, Arkansas
NPI 1164412243

Russellville Gynecology Clinic is a Gynecology Physician based in Russellville, AR and is specialized in Gynecology. Russellville Gynecology Clinic practices in Russellville, AR. The NPI Number for Russellville Gynecology Clinic is 1164412243 and holds a License No. C4687 (Arkansas).

The current practice location address for Russellville Gynecology Clinic is 914 W B St, Russellville, AR and can be reached out via phone at 479-968-7909 and via fax at 479-968-6908.

Location: 914 W B St, Russellville, AR, 72801-3502
institution
Provider Profile Details
NPI Number
1164412243
Provider Name
Russellville Gynecology Clinic
Credential
Provider Entity Type
Organization
Address
914 W B St, Russellville, AR, 72801-3502
Phone Number
479-968-7909
Fax Number
479-968-6908
Provider Enumeration Date
10/28/2005
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
13403000000 01 AR QUALCHOICE NUMBER
7420060 01 AR UNITED HEALTHCARE NUMBER
0004567368 01 AR AETNA NUMBER
institution
Provider Business Practice Location Address Details
Address
914 W B St
City
State
Zip
72801-3502
Phone Number
479-968-7909
Fax Number
479-968-6908
person
Provider Business Mailing Address Details
Address
914 W B St
City
State
Zip
72801-3502
Phone Number
479-968-7909
Fax Number
479-968-6908
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Obstetrics & Gynecology
Speciality
Gynecology
Taxonomy
License No.
C4687 (Arkansas)
Definition
Definition to come...
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