| Keystone Family Clinic | |
|
11808 Highway 71 S Fort Smith AR 72916-9378 | |
| (479) 434-6140 | |
| (479) 434-6144 |
| Full Name | Keystone Family Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 11808 Highway 71 S, Fort Smith, Arkansas |
| Authorized Official Name and Position | Joshua Aaron Clark (OWNER) |
| Authorized Official Contact | 4794346140 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Keystone Family Clinic 11808 Highway 71 S Fort Smith AR 72916-9378 Ph: (479) 434-6140 | Keystone Family Clinic 11808 Highway 71 S Fort Smith AR 72916-9378 Ph: (479) 434-6140 |
| NPI Number | 1205280021 |
|---|---|
| Provider Enumeration Date | 04/18/2016 |
| Last Update Date | 08/08/2022 |
| Medicare PECOS PAC ID | 2668763178 |
|---|---|
| Medicare Enrollment ID | O20160614000205 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205280021 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Laura Leonard Adams |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740277557 PECOS PAC ID: 2365415742 Enrollment ID: I20040813001064 |
| Provider Name | Joshua A Clark |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1265632368 PECOS PAC ID: 4284787623 Enrollment ID: I20090731000571 |
| Provider Name | Amanda M Day |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558715987 PECOS PAC ID: 2163713694 Enrollment ID: I20160614000706 |
| Provider Name | Carrisa S Patrick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225516826 PECOS PAC ID: 4486906732 Enrollment ID: I20181015001804 |
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