MCCRORY FAMILY CLINIC PA NPI 1972613743

Clinic/Center (Rural Health) in Mccrory, AR

NPI 1972613743 Organization Clinic/Center Rural Health

About MCCRORY FAMILY CLINIC PA

Mccrory Family Clinic Pa is a primary care provider established in Mccrory, Arkansas specializing in clinic/center (rural health) . The NPI number of Mccrory Family Clinic Pa is 1972613743 and was assigned on August 2006. The practitioner's primary taxonomy code is 261QR1300X with license number MC-1803 (AR). The provider is registered as an organization and their NPI record was last updated 13 years ago. The authorized official of this NPI record is Fred E Wilson Md (Md)

A primary care provider (PCP) like Mccrory Family Clinic Pa sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc

NPI

1972613743

Provider NameMCCRORY FAMILY CLINIC PA
Provider Location Address908 N EDMONDS AVE MCCRORY, AR 72101
Provider Mailing AddressPO BOX 780 MCCRORY, AR 72101
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?No
Enumeration Date08-30-2006
Last Update Date06-09-2008


Primary Taxonomy

Taxonomy Code261QR1300X
ClassificationClinic/Center
TypeAmbulatory Health Care Facilities
SpecializationRural Health
License No.MC-1803
License StateAR

Business Address

MCCRORY FAMILY CLINIC PA
908 N EDMONDS AVE
MCCRORY, AR
ZIP 72101
Phone: (870) 731-1100
Fax: (870) 731-1019

Get Directions


Mailing Address

MCCRORY FAMILY CLINIC PA
PO BOX 780
MCCRORY, AR
ZIP 72101
Phone: (870) 731-1100
Fax: (870) 731-1019



Authorized Official

Authorized Official Name FRED E WILSON MD
Authorized Official TitleMD
Authorized Official Phone(870) 731-1100

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
CI5031OTHER (01)AR
043844MEDICARE ID-TYPE UNSPECIFIED (04)AR
134474729MEDICAID (05)AR
5C026MEDICARE ID-TYPE UNSPECIFIED (04)AR
134056002MEDICAID (05)AR

Other Providers at the same location


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

NPI Name / Type Taxonomy Address
1255887550 REBECCA JANE O'SHIELDS APRN
Individual
Nurse Practitioner (Family)908 N EDMONDS AVE
MC CRORY, AR 72101
(870) 731-0509

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.