National Provider Identifier Database

ADVANCED MEDICINE OF THE OZARKS LTD
Family


Contact Information

ADVANCED MEDICINE OF THE OZARKS, LTD
104 DYER ST
MOUNTAIN HOME, AR72653-3514
Phone: 870-232-0397
Fax: 870-232-0399
Website:
Specialty Taxonomy Code
* Family 363LF0000X

* Indicates primary specialty

NPI Profile & details for ADVANCED MEDICINE OF THE OZARKS, LTD

NPI Number 1225786916
Legal business name
LBN
ADVANCED MEDICINE OF THE OZARKS, LTD
Authorized official TRACIE GILLILAND - (NURSE PRACTITIONER)
Entity Organization
Organization subpart No
Enumeration date 03/12/2022
Last updated 03/12/2022 - About 4 years ago
Sole proprietor1 Not specified
Identifiers n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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