Main Street Medical Clinic, P.A.

LBN: Main Street Medical Clinic, P.A.
Main Street Medical Clinic, P.A. is an health care organization with primary practice located at 722 N Main St , Benton AR 72015-3337. The organization recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Pediatrics. Allopathic & Osteopathic Physicians / Internal Medicine is the primary health care specialty. Main Street Medical Clinic, P.A. can be contacted via phone (501) 315-0059, or through Wilchman, Sheryl via phone (501) 315-0059.

Contact Information

Primary practice address
722 N Main St Benton AR 72015-3337
Phone: (501) 315-0059
Fax: (501) 315-1320
Website:
Map and Directions
Authorized official contact:
Name: Wilchman, Sheryl
Phone: (501) 315-0059

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X MC-2252 Arkansas
Allopathic & Osteopathic Physicians / Pediatrics 208000000X MC-2252 Arkansas

Profile Details

NPI number 1841298791
LBN Legal business name Main Street Medical Clinic, P.A.
DBA Doing business as
Authorized official Wilchman, Sheryl
Entity Organization
Organization subpart 1 No
Enumeration date Jul 13th, 2005
Last updated May 20th, 2021 - about 3 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 1841298791 NPPES
Arkansas MEDICAID 150521002

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