| The Broughton Clinic | |
|
1726 W 42nd Ave Pine Bluff AR 71603-7008 | |
| (870) 535-6800 | |
| (870) 535-6805 |
| Full Name | The Broughton Clinic |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 1726 W 42nd Ave, Pine Bluff, Arkansas |
| Authorized Official Name and Position | Stephen a Broughton (PHYSICIAN) |
| Authorized Official Contact | 8705356800 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| The Broughton Clinic 1726 W 42nd Ave Pine Bluff AR 71603-7008 Ph: (870) 535-6800 | The Broughton Clinic 1726 W 42nd Ave Pine Bluff AR 71603-7008 Ph: (870) 535-6800 |
| NPI Number | 1477578326 |
|---|---|
| Provider Enumeration Date | 07/13/2006 |
| Last Update Date | 04/23/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477578326 | NPI | - | NPPES |
| 139067002 | Medicaid | AR | |
| P002036692 | Other | PALMETTO GBA PART B |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | E0252 (Arkansas) | Primary |
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