Richard T Pruiksma, MD | |
500 S Mount Olive St, Suite 200, Siloam Springs, AR 72761-3602 | |
(479) 524-9550 | |
(479) 524-9552 |
Full Name | Richard T Pruiksma |
---|---|
Gender | Male |
Speciality | Family Medicine |
Location | 500 S Mount Olive St, Siloam Springs, Arkansas |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1053357491 | NPI | - | NPPES |
351793 | Other | AR | MEDICARE ID |
E-0221 | Other | AR | LICENSE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 20107 (Oklahoma) | Secondary |
207Q00000X | Family Medicine | 04-28209 (Kansas) | Secondary |
207Q00000X | Family Medicine | E-0221 (Arkansas) | Primary |
Entity Name | Su Clinica Familiar |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1285643304 PECOS PAC ID: 5496663429 Enrollment ID: O20040121001155 |
Entity Name | Ea Health Physicians Medical Group Texas Pa |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1063786523 PECOS PAC ID: 2769645563 Enrollment ID: O20120515000031 |
Mailing Address | Practice Location Address |
---|---|
Richard T Pruiksma, MD 614 E Emma Avenue, Suite 300, Springdale, AR 72764-4469 Ph: (479) 751-7417 | Richard T Pruiksma, MD 500 S Mount Olive St, Suite 200, Siloam Springs, AR 72761-3602 Ph: (479) 524-9550 |
Dr. Dan J Springer, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 451 S Holly St, Siloam Springs, AR 72761 Phone: 479-524-3141 Fax: 479-524-3090 | |
Dr. George H Benjamin, M.D. Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 451 S Holly St, Siloam Springs, AR 72761 Phone: 479-524-3141 Fax: 479-549-4601 | |
Jordyn Elizabeth Temple, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 451 S Holly St, Siloam Springs, AR 72761 Phone: 479-524-3141 | |
Dr. Scott G Stinnett, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 451 S Holly St, Siloam Springs, AR 72761 Phone: 479-524-3141 Fax: 479-524-3090 | |
Lori Lynn Douglas, Family Medicine Medicare: Medicare Enrolled Practice Location: 3721 Highway 412 E Ste B, Siloam Springs, AR 72761 Phone: 479-215-3080 | |
Dr. Roger W Youmans, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 451 S Holly St, Siloam Springs, AR 72761 Phone: 479-524-3141 Fax: 479-524-3090 |