St. Mary's Specialty LLC

NPI #1831730670 in Russellville, Arkansas

Provider Information

NPI Number: 1831730670
Entity Type: Organization
Organization Name: St. Mary's Specialty LLC
Primary Specialty: Anesthesiology
Enumeration Date: Oct 2, 2019
Last Updated: Feb 11, 2022

Practice Location

Address: 1808 W MAIN ST
City: Russellville
State: Arkansas
ZIP Code: 72801-2724
Phone: (479) 968-2841

Authorized Official

Name: TERRANCE DILLON
Title: ASSISTANT SECRETARY
Phone: (502) 596-7220

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Anesthesiology	207L00000X	Primary

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