Jeffrey Dale Grills, MD | |
2601 Gene George Blvd, Springdale, AR 72762 | |
(479) 725-6977 | |
(479) 725-6577 |
Full Name | Jeffrey Dale Grills |
---|---|
Gender | Male |
Speciality | Pediatrics |
Location | 2601 Gene George Blvd, Springdale, Arkansas |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1063449049 | NPI | - | NPPES |
100250370B | Medicaid | OK | |
107500 | Other | MO | ANTHEM |
208684605 | Medicaid | MO | |
100289710A | Medicaid | KS | |
224757001 | Medicaid | AR |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208000000X | Pediatrics | 112085 (Missouri) | Secondary |
208000000X | Pediatrics | E10930 (Arkansas) | Primary |
Entity Name | Arkansas Childrens Medical Group Pllc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1396274841 PECOS PAC ID: 7719252139 Enrollment ID: O20171010002445 |
Mailing Address | Practice Location Address |
---|---|
Jeffrey Dale Grills, MD 1 Childrens Way # 844, Little Rock, AR 72202-3500 Ph: (501) 364-2090 | Jeffrey Dale Grills, MD 2601 Gene George Blvd, Springdale, AR 72762 Ph: (479) 725-6977 |
Dr. Olabode Olaosebikan Desalu, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 2601 Gene George Blvd, Springdale, AR 72762 Phone: 479-725-6977 Fax: 479-725-6577 | |
Casie Marie James, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 2601 Gene George Blvd, Springdale, AR 72762 Phone: 479-725-6866 Fax: 479-725-6868 | |
Dr. Sarah Morris Weston, M.D. Pediatrics Medicare: Accepting Medicare Assignments Practice Location: 2601 Gene George Blvd, Springdale, AR 72762 Phone: 479-725-6977 Fax: 479-725-6577 | |
Andrew Arthur Martin, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 2601 Gene George Blvd, Springdale, AR 72762 Phone: 794-725-6801 Fax: 479-725-6577 | |
Sarah Jeffreys, Pediatrics Medicare: Medicare Enrolled Practice Location: 2601 Gene George Blvd, Springdale, AR 72762 Phone: 479-725-6801 Fax: 479-725-6577 | |
Dr. Hilary H Mcclafferty, MD Pediatrics Medicare: Accepting Medicare Assignments Practice Location: 2601 Gene George Blvd, Springdale, AR 72762 Phone: 479-725-6801 Fax: 479-725-6577 |