Lake Village Clinic Pa

LBN: Lake Village Clinic Pa
Lake Village Clinic Pa is an health care organization with primary practice located at 2918 Louis Sessions St , Lake Village AR 71653-6049. The organization recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / General Practice, Ambulatory Health Care Facilities / Rural Health. Ambulatory Health Care Facilities / Rural Health is the primary health care specialty. Lake Village Clinic Pa can be contacted via phone (870) 265-5343, or through Howell, Suzanne via phone (870) 265-5343.

Contact Information

Primary practice address
2918 Louis Sessions St Lake Village AR 71653-6049
Fax: (870) 265-5686
Website:
Authorized official contact:
Name: Howell, Suzanne

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / General Practice 208D00000X MC0189 Arkansas
Ambulatory Health Care Facilities / Rural Health 261QR1300X MC0189 Arkansas

Profile Details

NPI number 1306801212
LBN Legal business name Lake Village Clinic Pa
DBA Doing business as
Authorized official Howell, Suzanne
Entity Organization
Organization subpart 1 No
Enumeration date Apr 20th, 2006
Last updated Dec 9th, 2015 - about 11 years ago

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 1306801212 NPPES
Arkansas MEDICAID 101409002
Arkansas MEDICAID 127181729

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