Lavaca Wellness Clinic, P.a.

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

LAVACA WELLNESS CLINIC, P.A.

Practice address

603 S Division St
Lavaca, AR 72941-4129

Phone

(479) 674-9181

Fax

(479) 674-8105

NPI assigned

Nov 17, 2010

Last updated

Nov 17, 2010By 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

Robert E. Sanders, D.O.NPI 1932188216

Title

Owner

Phone

(479) 462-7203

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, and the practitioner matching its NPPES authorized official.

• Robert E. Sanders, D.O.

  • Internal Medicine Physician
  • Cookson, OK
  • NPI 1932188216
  Authorized official Same address or phone

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

{
    "created_epoch": "1289952000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1289952000000",
    "number": "1821390287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "603 S DIVISION ST",
            "city": "LAVACA",
            "state": "AR",
            "postal_code": "729414129",
            "telephone_number": "479-674-9181",
            "fax_number": "479-674-8105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "603 S DIVISION ST",
            "city": "LAVACA",
            "state": "AR",
            "postal_code": "729414129",
            "telephone_number": "479-674-9181",
            "fax_number": "479-674-8105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAVACA WELLNESS CLINIC, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-17",
        "last_updated": "2010-11-17",
        "status": "A",
        "authorized_official_last_name": "SANDERS",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "479-462-7203",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• HNK Pharm, PLLC
• HNK Pharm, PLLC LTC (Health-Wise Pharmacy of Lavaca LTC)
• Kelly Jo Hubbard, APN
• Lavaca Family Clinic
• Lavaca School District
• Cynthia Leach
• Little Roots Therapy, LLC (Katie Davidson)
• River Valley Primary Care Services (Lavaca Family Dental)
• River Valley Primary Care Services (Lavaca Wellness Center)
• Kaylee Taylor

• Primary Care Clinic/Center in Lavaca, AR
• Providers in Lavaca, AR by specialty
• Primary Care Clinic/Center in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2010; 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.