Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.

Russellville Dermatology Clinic PA

Organization Procedural Dermatology Physician · NPI 1477529436

Russellville Dermatology Clinic PA provides Procedural Dermatology Physician services in Russellville, Arkansas. Licensed in Arkansas. Registered with an NPI since 2006.

Licensed in
AR
In the registry since
2006
What do these letters mean?
PA — Professional association
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1602 W Main St
Russellville, AR 72801-2720
Phone: (479) 968-6969
Fax: (479) 968-4290
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Procedural Dermatology Physician (primary) Taxonomy 207NS0135X · Licence MC0841 (AR)

Record details

NPI number1477529436
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official William Galloway — President / Owner · (479) 968-6969
NPI enumeratedFebruary 28, 2006
Last updated in NPPESMarch 7, 2023
Mailing addressPo Box 843, Russellville, AR 72811-0843

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