Wynne Physicians Clinic LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

WYNNE PHYSICIANS CLINIC LLC

Practice address

710 Falls Blvd S
Wynne, AR 72396-3514

Phone

(870) 238-2321

Fax

(870) 238-0114

NPI assigned

Jan 20, 2020

Last updated

Jan 20, 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

Mr. John Lieblong

Title

President

Phone

(870) 932-7024

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Doctors Health Group, Inc

  dba Acute Care Center

  • Family Medicine Physician
  • Jonesboro, AR
  • NPI 1225091176

  Member Of

  NPD member

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

{
    "created_epoch": "1579478400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1579478400000",
    "number": "1710517677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1331",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724031331",
            "telephone_number": "870-932-7024",
            "fax_number": "870-930-9377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 FALLS BLVD S",
            "city": "WYNNE",
            "state": "AR",
            "postal_code": "723963514",
            "telephone_number": "870-238-2321",
            "fax_number": "870-238-0114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WYNNE PHYSICIANS CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-20",
        "last_updated": "2020-01-20",
        "certification_date": "2020-01-20",
        "status": "A",
        "authorized_official_last_name": "LIEBLONG",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "870-932-7024",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wynne Medical Clinic PA
• Wynne Medical Pharmacy Inc
• Wynne Medical Pharmacy of Cross County Inc
• Wynne Medical Pharmacy of Cross County Inc
• Wynne Medical Pharmacy of Cross County Inc
• Wynne Public Schools

• Family Medicine Physician in Wynne, AR
• Providers in Wynne, 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 Jan 20, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.