Basic Information
| Provider Information | |||||||||
| NPI: | 1841614930 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MCLAIN | ||||||||
| FirstName: | LAYNE | ||||||||
| MiddleName: | |||||||||
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| OtherLastName: | COLLINS | ||||||||
| OtherFirstName: | LAYNE | ||||||||
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| OtherCredential: | PA-C | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 860 HIGHWAY 62 E STE 10 | ||||||||
| Address2: | |||||||||
| City: | MOUNTAIN HOME | ||||||||
| State: | AR | ||||||||
| PostalCode: | 726533200 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8704243181 | ||||||||
| FaxNumber: | 8704243089 | ||||||||
| Practice Location | |||||||||
| Address1: | 4313 S PLEASANT CROSSING BLVD | ||||||||
| Address2: | |||||||||
| City: | ROGERS | ||||||||
| State: | AR | ||||||||
| PostalCode: | 727581347 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4793414003 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/10/2014 | ||||||||
| LastUpdateDate: | 01/14/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 01/14/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363AS0400X | PA-537 | AR | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Surgical |
No ID Information.