Organization · Type 2 NPI
Russellville Gastroenterology Clinic PA
Medical Specialty Clinic/Center · Russellville, AR
Practice location
1611 W Main St
Russellville, AR 72801-2719
Fax (479) 890-5092
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Medical Specialty Clinic/Center Primary | 261QM2500X | C6004 (AR) |
| Medical Specialty Clinic/Center | 261QM2500X | None listed |
Medical Specialty Clinic/Center: 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).
Another provider at this address
About NPI 1750579488
Russellville Gastroenterology Clinic PA's National Provider Identifier is 1750579488, issued on Oct 9, 2007. The primary taxonomy on file is Medical Specialty Clinic/Center (261QM2500X), and the practice location is in Russellville, AR. The record was last updated on Jan 22, 2015.