Organization Name: | HOPE FAMILY CLINIC PA |
NPI Number: | 1225468747 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | TONY ASBILLE (CLINIC ADMINISTRATOR) |
Mailing Address: | 100 E 20th St Hope |
State: | AR US |
Postal Code: | 718018213 |
Phone Number: | 8702895865 |
Fax Number: | |
NPI Enumeration Date: | 11/19/2013 |
NPI Last Update Date: | 11/19/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | A003958 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AR |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |