Basic Information
| Provider Information | |||||||||
| NPI: | 1871527002 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | HARRISON MEDIQUICK PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 1496 | ||||||||
| Address2: | 724 N SPRING ST | ||||||||
| City: | HARRISON | ||||||||
| State: | AR | ||||||||
| PostalCode: | 72602 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8707412500 | ||||||||
| FaxNumber: | 8707417618 | ||||||||
| Practice Location | |||||||||
| Address1: | 724 N SPRING STREET | ||||||||
| Address2: | |||||||||
| City: | HARRISON | ||||||||
| State: | AR | ||||||||
| PostalCode: | 72601 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8707412500 | ||||||||
| FaxNumber: | 8707417618 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/11/2006 | ||||||||
| LastUpdateDate: | 07/25/2008 | ||||||||
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| AuthorizedOfficialLastName: | PATTERSON | ||||||||
| AuthorizedOfficialFirstName: | GEORGE | ||||||||
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| AuthorizedOfficialTitleorPosition: | CEO PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 8707417612 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QU0200X | Y | Ambulatory Health Care Facilities | Clinic/Center | Urgent Care |
No ID Information.