Provider Demographics
NPI:1912329236
Name:ANTHONY ANSTON, DO, PLLC
Entity Type:Organization
Organization Name:ANTHONY ANSTON, DO, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:
Authorized Official - Last Name:ANSTON
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:870-214-0406
Mailing Address - Street 1:359 TEAGUE HIGHTOP RD
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN VIEW
Mailing Address - State:AR
Mailing Address - Zip Code:72560-6171
Mailing Address - Country:US
Mailing Address - Phone:870-214-0406
Mailing Address - Fax:
Practice Address - Street 1:359 TEAGUE HIGHTOP RD
Practice Address - Street 2:
Practice Address - City:MOUNTAIN VIEW
Practice Address - State:AR
Practice Address - Zip Code:72560-6074
Practice Address - Country:US
Practice Address - Phone:870-214-0406
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-07
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-7863261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center