| Mountainburg Family Clinic | |
|
#4 Highway 71 Ne Mountainburg AR 72946-0000 | |
| (479) 369-2091 | |
| (479) 369-4119 |
| Full Name | Mountainburg Family Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | #4 Highway 71 Ne, Mountainburg, Arkansas |
| Authorized Official Name and Position | Jerome Jospeh White (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 4794312057 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mountainburg Family Clinic Po Box 130 Ratcliff AR 72951-0130 Ph: (479) 635-0091 | Mountainburg Family Clinic #4 Highway 71 Ne Mountainburg AR 72946-0000 Ph: (479) 369-2091 |
| NPI Number | 1639302896 |
|---|---|
| Provider Enumeration Date | 09/03/2009 |
| Last Update Date | 06/15/2023 |
| Medicare PECOS PAC ID | 0042274276 |
|---|---|
| Medicare Enrollment ID | O20091106000501 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639302896 | NPI | - | NPPES |
| 180402749 | Medicaid | AR | |
| 771108349 | Medicaid | AR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Mountainburg Family Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: #4 Hwy 71 Ne, Mountainburg, AR 72946 Phone: 479-369-2091 Fax: 479-369-4119 |