Inis Jane Bardella, MD | |
1617 N Washington, Magnolia, AR 71753-2046 | |
(870) 562-2588 | |
Not Available |
Full Name | Inis Jane Bardella |
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Gender | Female |
Speciality | Family Medicine |
Location | 1617 N Washington, Magnolia, Arkansas |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1124084926 | NPI | - | NPPES |
200496730 | Medicaid | IN | |
PENDING | Medicaid | CO | |
036129581 | Other | IL | ILLINOIS PHYSICIAN LICENSE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | E-12712 (Arkansas) | Primary |
207Q00000X | Family Medicine | 036129581 (Illinois) | Secondary |
Entity Name | The Board Of Trustees Of The University Of Illinois |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1386863819 PECOS PAC ID: 3072422716 Enrollment ID: O20031112000158 |
Mailing Address | Practice Location Address |
---|---|
Inis Jane Bardella, MD 4021 W 8th St, Little Rock, AR 72204-2029 Ph: (501) 686-5021 | Inis Jane Bardella, MD 1617 N Washington, Magnolia, AR 71753-2046 Ph: (870) 562-2588 |
Matthew E. Barnett, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 211 E Stadium, Magnolia, AR 71753 Phone: 870-234-3042 | |
Rodney L Griffin, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 211 E Stadium, Magnolia, AR 71753 Phone: 870-234-5995 Fax: 870-234-0278 | |
John Eric Henriksen, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 101 Hospital Drive, Magnolia, AR 71753 Phone: 870-235-3000 Fax: 870-235-3557 | |
Dr. Franklin Dowling Roberts, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1327 N Washington, Magnolia, AR 71753 Phone: 870-234-8430 Fax: 870-234-1417 | |
Dr. Michael G Page, DO Family Medicine Medicare: Medicare Enrolled Practice Location: 1617 N Washington, Magnolia, AR 71753 Phone: 870-234-7676 Fax: 870-562-2559 | |
Dr. James William Chambliss, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1701 E North St, Magnolia, AR 71753 Phone: 870-234-3802 Fax: 870-234-7386 |