Provider Demographics
NPI:1225317159
Name:HOUSE CALLS, ON CALL
Entity Type:Organization
Organization Name:HOUSE CALLS, ON CALL
Other - Org Name:COMMUNITY MEDICAL CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:WESLEY
Authorized Official - Middle Name:FRANK
Authorized Official - Last Name:WARD
Authorized Official - Suffix:
Authorized Official - Credentials:APN
Authorized Official - Phone:501-505-8349
Mailing Address - Street 1:2920 ADAM ST
Mailing Address - Street 2:
Mailing Address - City:CONWAY
Mailing Address - State:AR
Mailing Address - Zip Code:72034-5502
Mailing Address - Country:US
Mailing Address - Phone:501-358-9942
Mailing Address - Fax:501-358-4901
Practice Address - Street 1:2920 ADAM ST
Practice Address - Street 2:
Practice Address - City:CONWAY
Practice Address - State:AR
Practice Address - Zip Code:72034-5502
Practice Address - Country:US
Practice Address - Phone:501-358-9942
Practice Address - Fax:501-358-4901
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-09
Last Update Date:2013-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARAO2979261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care