Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

St Mary's Physician Services LLC

Organization Internal Medicine Physician · NPI 1124084991

St Mary's Physician Services LLC is an Internal Medicine Physician in Russellville, Arkansas. Registered with an NPI since 2006.

In the registry since
2006
Specialties on file
2
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

101 Skyline Dr
Russellville, AR 72801-3363
Phone: (479) 968-2345
Fax: (479) 890-2497
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

General Practice Physician (primary) Taxonomy 208D00000X
Internal Medicine Physician Taxonomy 207R00000X

Record details

NPI number1124084991
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Charlotte Lawrence — Secretary · (615) 920-7000
NPI enumeratedApril 21, 2006
Last updated in NPPESSeptember 26, 2024
Certification dateSeptember 26, 2024
Mailing address101 Skyline Dr, Russellville, AR 72801-3363

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