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Russellville Gastroenterology Clinic Pa
Medical Specialty Clinic/Center in Russellville, Arkansas
NPI 1750579488

Russellville Gastroenterology Clinic Pa is a Medical Specialty Clinic/Center based in Russellville, AR and is specialized in Medical Specialty. Russellville Gastroenterology Clinic Pa practices in Russellville, AR. The NPI Number for Russellville Gastroenterology Clinic Pa is 1750579488 and holds a License No. C6004 (Arkansas).

The current practice location address for Russellville Gastroenterology Clinic Pa is 1611 W Main St, Russellville, AR and can be reached out via phone at 479-890-5881 and via fax at 479-890-5092.

Location: 1611 W Main St, Russellville, AR, 72801-2719
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1750579488
Provider Name
Russellville Gastroenterology Clinic Pa
Credential
Provider Entity Type
Organization
Address
1611 W Main St, Russellville, AR, 72801-2719
Phone Number
479-890-5881
Fax Number
479-890-5092
Provider Enumeration Date
10/09/2007
Last Update Date
03/12/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
112265001 05 AR
institution
Provider Business Practice Location Address Details
Address
1611 W Main St
City
Russellville
State
Arkansas
Zip
72801-2719
Phone Number
479-890-5881
Fax Number
479-890-5092
person
Provider Business Mailing Address Details
Address
1611 W Main St
City
Russellville
State
Arkansas
Zip
72801-2719
Phone Number
479-890-5881
Fax Number
479-890-5092
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Medical Specialty
Taxonomy
261QM2500X
License No.
C6004 (Arkansas)
Definition
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer).
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