Provider Demographics
NPI:1306370630
Name:MEDWORKS LLC
Entity Type:Organization
Organization Name:MEDWORKS LLC
Other - Org Name:ARKANSAS MEDICAL CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPERATOR
Authorized Official - Prefix:
Authorized Official - First Name:SHIRRANNA
Authorized Official - Middle Name:M
Authorized Official - Last Name:TODD
Authorized Official - Suffix:
Authorized Official - Credentials:BA
Authorized Official - Phone:479-966-4999
Mailing Address - Street 1:986 ELMWOOD
Mailing Address - Street 2:SUITE C
Mailing Address - City:SPRINGDALE
Mailing Address - State:AR
Mailing Address - Zip Code:72762
Mailing Address - Country:US
Mailing Address - Phone:479-966-4999
Mailing Address - Fax:479-966-4987
Practice Address - Street 1:986 ELMWOOD
Practice Address - Street 2:SUITE C
Practice Address - City:SPRINGDALE
Practice Address - State:AR
Practice Address - Zip Code:72762
Practice Address - Country:US
Practice Address - Phone:479-966-4999
Practice Address - Fax:479-966-4987
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-13
Last Update Date:2017-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE2474207R00000X
ARN7877208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty