| Pointer Trail Family Clinic Pllc | |
|
109 W Pointer Trail Van Buren AR 72956-5321 | |
| (479) 922-2222 | |
| (479) 922-2227 |
| Full Name | Pointer Trail Family Clinic Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 109 W Pointer Trail, Van Buren, Arkansas |
| Authorized Official Name and Position | Carolyn M Dillard (OWNER PHYSICIAN) |
| Authorized Official Contact | 4799222222 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pointer Trail Family Clinic Pllc 109 W Pointer Trail Van Buren AR 72956-5321 Ph: (479) 922-2222 | Pointer Trail Family Clinic Pllc 109 W Pointer Trail Van Buren AR 72956-5321 Ph: (479) 922-2222 |
| NPI Number | 1578684148 |
|---|---|
| Provider Enumeration Date | 04/02/2007 |
| Last Update Date | 10/13/2014 |
| Medicare PECOS PAC ID | 6103918925 |
|---|---|
| Medicare Enrollment ID | O20070824000546 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578684148 | NPI | - | NPPES |
| 5F756 | Other | AR | GROUP MEDICARE NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | MC2545 (Arkansas) | Primary |
| Provider Name | Carolyn M Dillard |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1396790721 PECOS PAC ID: 0345227807 Enrollment ID: I20040701001375 |
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