Provider Demographics
NPI:1144755570
Name:ACCESS MEDICAL CLINIC ARKANSAS LLC
Entity Type:Organization
Organization Name:ACCESS MEDICAL CLINIC ARKANSAS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:BRADLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:BIBB
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:870-856-1202
Mailing Address - Street 1:4196 HIGHWAY 62 412 STE A
Mailing Address - Street 2:
Mailing Address - City:HARDY
Mailing Address - State:AR
Mailing Address - Zip Code:72542-8002
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:16723 HWY 62
Practice Address - Street 2:
Practice Address - City:GARFIELD
Practice Address - State:AR
Practice Address - Zip Code:72732
Practice Address - Country:US
Practice Address - Phone:479-359-2151
Practice Address - Fax:870-895-2144
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-24
Last Update Date:2020-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health