Ferdinand K Samuel, MD | |
1801 W 40th Ave, Ste 2b, Pine Bluff, AR 71603-6957 | |
(870) 535-7457 | |
(870) 535-2522 |
Full Name | Ferdinand K Samuel |
---|---|
Gender | Male |
Speciality | Anesthesiology |
Location | 1801 W 40th Ave, Pine Bluff, Arkansas |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1174528186 | NPI | - | NPPES |
54658 | Other | AR | BCBS |
AR6003787 | Other | TRICARE/HUMANA | |
050019321 | Other | RAILROAD MEDICARE/PGBA | |
103013001 | Medicaid | AR |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207L00000X | Anesthesiology | R2879 (Arkansas) | Primary |
Entity Name | Premier Anesthesia Of Arkansas Professional Corporation |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1932519485 PECOS PAC ID: 6406077460 Enrollment ID: O20141016002060 |
Entity Name | Jefferson Regional Anesthesia Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1205301587 PECOS PAC ID: 6204171846 Enrollment ID: O20181231000163 |
Mailing Address | Practice Location Address |
---|---|
Ferdinand K Samuel, MD Po Box 1272, Pine Bluff, AR 71613-1272 Ph: (870) 535-7457 | Ferdinand K Samuel, MD 1801 W 40th Ave, Ste 2b, Pine Bluff, AR 71603-6957 Ph: (870) 535-7457 |
Fawad H Walajahi, M.D. Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 1801 W 40th Ave, Ste 2b, Pine Bluff, AR 71603 Phone: 870-535-7457 Fax: 870-535-2522 | |
Charles J Stearns, MD Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 1801 W 40th Ave, Suite 2b, Pine Bluff, AR 71603 Phone: 870-535-7457 Fax: 870-535-2522 | |
Jeffrey S Bryles, M.D. Anesthesiology Medicare: Not Enrolled in Medicare Practice Location: 1801 W 40th Ave, Ste 2b, Pine Bluff, AR 71603 Phone: 870-535-7457 Fax: 870-535-2522 |