| Throneberry Family Clinic, P.a. | |
|
2869 College Ave Conway AR 72034-6087 | |
| (501) 327-2611 | |
| (501) 336-9763 |
| Full Name | Throneberry Family Clinic, P.a. |
|---|---|
| Speciality | Clinic/Center |
| Location | 2869 College Ave, Conway, Arkansas |
| Authorized Official Name and Position | James Barton Throneberry (OWNER) |
| Authorized Official Contact | 5013272611 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Throneberry Family Clinic, P.a. 2869 College Ave Conway AR 72034-6087 Ph: (501) 327-2611 | Throneberry Family Clinic, P.a. 2869 College Ave Conway AR 72034-6087 Ph: (501) 327-2611 |
| NPI Number | 1538296256 |
|---|---|
| Provider Enumeration Date | 02/28/2007 |
| Last Update Date | 05/04/2021 |
| Medicare PECOS PAC ID | 6507874815 |
|---|---|
| Medicare Enrollment ID | O20110613000587 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538296256 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | MC1741 (Arkansas) | Primary |
| Provider Name | James Throneberry |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1316949308 PECOS PAC ID: 2769444751 Enrollment ID: I20060328000381 |
| Provider Name | Brandon M. Thurow |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1033346358 PECOS PAC ID: 4688853203 Enrollment ID: I20110127000674 |
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