Russellville Dermatology Clinic Pa

LBN: Russellville Dermatology Clinic Pa
Russellville Dermatology Clinic Pa is an health care organization with primary practice located at 1602 W Main St , Russellville AR 72801-2720. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Procedural Dermatology, which is considered as the primary health care specialty. Russellville Dermatology Clinic Pa can be contacted via phone (479) 968-6969, or through Galloway, William W via phone (479) 968-6969.

Contact Information

Primary practice address
1602 W Main St Russellville AR 72801-2720
Phone: (479) 968-6969
Fax: (479) 968-4290
Website:
Map and Directions
Authorized official contact:
Name: Galloway, William W Doctor of Medicine (MD)
Phone: (479) 968-6969

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Procedural Dermatology 207NS0135X MC0841 Arkansas

Profile Details

NPI number 1477529436
LBN Legal business name Russellville Dermatology Clinic Pa
DBA Doing business as
Authorized official Galloway, William W Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Feb 28th, 2006
Last updated Mar 7th, 2023 - about last year

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 1477529436 NPPES
Arkansas MEDICAID 110005002

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