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:
Health care specialties
| Specialty | Code | License # | 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 4 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1841298791 | NPPES |
| Arkansas | MEDICAID | 150521002 |
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