Clarksville Medical Group, P.A.

LBN: Clarksville Medical Group, P.A.
Clarksville Medical Group, P.A. is an health care organization with primary practice located at 601 W Mckennon St , Clarksville AR 72830-3523. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as the primary health care specialty. Clarksville Medical Group, P.A. can be contacted via phone (479) 754-8384, or through Graves, Ali via phone (479) 754-0804.

Contact Information

Primary practice address
601 W Mckennon St Clarksville AR 72830-3523
Phone: (479) 754-8384
Fax: (479) 754-7141
Website:
Map and Directions
Authorized official contact:
Name: Graves, Ali CPCO
Phone: (479) 754-0804

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X MC-0283 Arkansas

Profile Details

NPI number 1447253810
LBN Legal business name Clarksville Medical Group, P.A.
DBA Doing business as
Authorized official Graves, Ali CPCO
Entity Organization
Organization subpart 1 No
Enumeration date May 31st, 2005
Last updated Jun 26th, 2025 - about last year

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1447253810 NPPES
Arkansas MEDICAID 103094002
Arkansas Other 56716

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