Provider Demographics
NPI:1316916802
Name:SALEM CLINIC PLLC
Entity type:Organization
Organization Name:SALEM CLINIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:GRIFFIN
Authorized Official - Middle Name:A
Authorized Official - Last Name:ARNOLD
Authorized Official - Suffix:II
Authorized Official - Credentials:MD
Authorized Official - Phone:870-895-3281
Mailing Address - Street 1:PO BOX 457
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:AR
Mailing Address - Zip Code:72576-0457
Mailing Address - Country:US
Mailing Address - Phone:870-895-3281
Mailing Address - Fax:870-895-3118
Practice Address - Street 1:661 N MAIN ST
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:AR
Practice Address - Zip Code:72576-9451
Practice Address - Country:US
Practice Address - Phone:870-895-3281
Practice Address - Fax:870-895-3118
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-16
Last Update Date:2007-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARC7652261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
ARC7652OtherGA PERSONAL LICENSE NUMBE
ARANP1006OtherRA PERSONAL LICENSE #
AR56958Medicare ID - Type UnspecifiedFACILITY MEDICARE NUMBER
ARC7652OtherGA PERSONAL LICENSE NUMBE
ARE10472Medicare UPIN