South Logan Family Practice

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

E3514 Issued in AR

Legal business name

SOUTH LOGAN FAMILY PRACTICE

Practice address

1808 East Main
Booneville, AR 72927-1373

Phone

(479) 675-2228

Fax

(479) 675-2274

NPI assigned

May 25, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Clarence Jay Arendall, M.D.

Title

Medical Doctor

Phone

(479) 675-2228

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Billy H Noel, APN

  • General Practice Registered Nurse
  • Fort Smith, AR
  • NPI 1790716314
  NPD (past)

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

{
    "created_epoch": "1180051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214956800000",
    "number": "1447461900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1373",
            "city": "BOONEVILLE",
            "state": "AR",
            "postal_code": "729270301",
            "telephone_number": "479-675-2228",
            "fax_number": "479-675-2274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1808 EAST MAIN",
            "city": "BOONEVILLE",
            "state": "AR",
            "postal_code": "729271373",
            "telephone_number": "479-675-2228",
            "fax_number": "479-675-2274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH LOGAN FAMILY PRACTICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-25",
        "last_updated": "2008-07-02",
        "status": "A",
        "authorized_official_last_name": "ARENDALL",
        "authorized_official_first_name": "CLARENCE",
        "authorized_official_middle_name": "JAY",
        "authorized_official_title_or_position": "MEDICAL DOCTOR",
        "authorized_official_telephone_number": "479-675-2228",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "E3514",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Drake Schichtl
• J Thad Shirey, DDS
• Rebecca Shurden, PTA
• Rachel Beth Sing, M.D.
• Smee Drug Store Inc
• Cole Havard Stanton, OD
• State of Arkansas
• State of Arkansas
• William Andrew Stevenson IV, M.D.
• Virginia L Strickland, APRN

• All providers in Booneville, AR
• Family Medicine Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2008; 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.