DEWITT FAMILY PRACTICE NPI 1932114725

Clinic/Center (Health Service) in Dewitt, AR

NPI 1932114725 Organization Clinic/Center Health Service

About DEWITT FAMILY PRACTICE

Dewitt Family Practice is a provider established in Dewitt, Arkansas specializing in clinic/center (health service) . The NPI number of Dewitt Family Practice is 1932114725 and was assigned on July 2006. The practitioner's primary taxonomy code is 261QH0100X with license number A01288ANP (AR). The provider is registered as an organization and their NPI record was last updated one year ago. The authorized official of this NPI record is Debra Charlene West Apn (Apn/owner)

NPI

1932114725

Provider NameDEWITT FAMILY PRACTICE
Provider Location Address609 W 13TH ST DEWITT, AR 72042
Provider Mailing Address609 W 13TH ST PO BOX 607 DEWITT, AR 72042
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?No
Enumeration Date07-30-2006
Last Update Date08-22-2020


Primary Taxonomy

Taxonomy Code261QH0100X
ClassificationClinic/Center
TypeAmbulatory Health Care Facilities
SpecializationHealth Service
License No.A01288ANP
License StateAR

Business Address

DEWITT FAMILY PRACTICE
609 W 13TH ST
DEWITT, AR
ZIP 72042
Phone: (870) 946-1120
Fax: (870) 946-1132

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Mailing Address

DEWITT FAMILY PRACTICE
609 W 13TH ST
PO BOX 607
DEWITT, AR
ZIP 72042
Phone: (870) 946-1120
Fax: (870) 946-1132



Authorized Official

Authorized Official Name DEBRA CHARLENE WEST APN
Authorized Official TitleAPN/OWNER
Authorized Official Phone(870) 946-1120

Other Providers at the same location


The following provider is registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1023082575 DEBRA CHARLENE WEST APN
Individual
Nurse Practitioner (Family)609 W 13TH ST
DE WITT, AR 72042
(870) 946-1120

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.