Marianna Family Medicine Clinic PLLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

MARIANNA FAMILY MEDICINE CLINIC PLLC

Practice address

29 West Tennessee Street
Marianna, AR 72360

Phone

(870) 295-2543

Fax

(870) 295-4634

NPI assigned

Oct 17, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Lynn Chang Ly

Title

Office Manager

Phone

(870) 295-2543

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Phuong CHI Ly, MD

  • Family Medicine Physician
  • Mission Viejo, CA
  • NPI 1265512982
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1073693701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29 WEST TENNESSEE STREET",
            "city": "MARIANNA",
            "state": "AR",
            "postal_code": "72360",
            "telephone_number": "870-295-2543",
            "fax_number": "870-295-4634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29 WEST TENNESSEE STREET",
            "city": "MARIANNA",
            "state": "AR",
            "postal_code": "72360",
            "telephone_number": "870-295-2543",
            "fax_number": "870-295-4634"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARIANNA FAMILY MEDICINE CLINIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CHANG LY",
        "authorized_official_first_name": "LYNN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "870-295-2543"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lee County Cooperative Clinic
• Lee County Cooperative Clinic
• Lee County School District
• Shirleta Lee
• Abe Lovelace, LMSW
• Ashley McCoy, RN
• Kimberly McFadden
• Charlotte McKee, RN
• Dixie Quinn Meyer, OTR
• Harry Andre Michel, M.D.

• Family Medicine Physician in Marianna, AR
• Providers in Marianna, AR by specialty
• Family Medicine Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.