Mid-South Multi Specialty Clinic

LBN: Crittenden Hospital Association
Mid-South Multi Specialty Clinic is an health care organization with primary practice located at 228 W Tyler Ave Suite 105, West Memphis AR 72301-4223. The organization recently has 4 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Infectious Disease, Allopathic & Osteopathic Physicians / Pulmonary Disease, Allopathic & Osteopathic Physicians / Orthopaedic Surgery. Allopathic & Osteopathic Physicians / Infectious Disease is the primary health care specialty. Crittenden Hospital Association can be contacted via phone (870) 735-4025, or through Mccormick, William B via phone (870) 735-1500.

Contact Information

Primary practice address
228 W Tyler Ave Suite 105 West Memphis AR 72301-4223
Phone: (870) 735-4025
Fax: (870) 735-0570
Website:
Map and Directions
Authorized official contact:
Name: Mccormick, William B
Phone: (870) 735-1500

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X N8431 Arkansas
Allopathic & Osteopathic Physicians / Infectious Disease 207RI0200X
Allopathic & Osteopathic Physicians / Pulmonary Disease 207RP1001X
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X

Profile Details

NPI number 1700842994
LBN Legal business name Crittenden Hospital Association
DBA Doing business as Mid-South Multi Specialty Clinic
Authorized official Mccormick, William B
Entity Organization
Organization subpart 1 No
Enumeration date Apr 25th, 2006
Last updated Feb 26th, 2014 - about 10 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 1700842994 NPPES
Arkansas Other 5F794 BLUE CROSS GROUP
Arkansas MEDICAID 166512002 BLUE CROSS GROUP

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