Provider Demographics
NPI:1346478484
Name:FAMILY ENT & SINUS CENTER OF HARRISON, P.A.
Entity type:Organization
Organization Name:FAMILY ENT & SINUS CENTER OF HARRISON, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:LOUISE
Authorized Official - Last Name:BELL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:870-741-4368
Mailing Address - Street 1:1401 MCCOY DRIVE
Mailing Address - Street 2:
Mailing Address - City:HARRISON
Mailing Address - State:AR
Mailing Address - Zip Code:72601-2417
Mailing Address - Country:US
Mailing Address - Phone:870-741-4368
Mailing Address - Fax:870-741-9515
Practice Address - Street 1:1401 MCCOY DRIVE
Practice Address - Street 2:
Practice Address - City:HARRISON
Practice Address - State:AR
Practice Address - Zip Code:72601-2417
Practice Address - Country:US
Practice Address - Phone:870-741-4368
Practice Address - Fax:870-741-9515
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-28
Last Update Date:2012-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ART2009-076207Y00000X
ARE-6167207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR178391002Medicaid