Riverside Medical Clinic

LBN: Riverside Medical Clinic
Riverside Medical Clinic is an health care organization with primary practice located at 803 Hwy 18 , Lake City AR 72347-0505. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as the primary health care specialty. Riverside Medical Clinic can be contacted via phone (870) 237-1055, or through Wagner, Tommy via phone (870) 561-3300.

Contact Information

Primary practice address
803 Hwy 18 Lake City AR 72347-0505
Phone: (870) 237-1055
Fax: (870) 237-1054
Website:
Map and Directions
Authorized official contact:
Name: Wagner, Tommy
Phone: (870) 561-3300

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X

Profile Details

NPI number 1811206923
LBN Legal business name Riverside Medical Clinic
DBA Doing business as
Authorized official Wagner, Tommy
Entity Organization
Organization subpart 1 No
Enumeration date Oct 7th, 2010
Last updated Aug 2nd, 2011 - about 15 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 1811206923 NPPES
Arkansas MEDICAID 187113002

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