| Baptist Health Family Clinic - Hillcrest | |
|
2601 Kavanaugh Blvd Suite 6 Little Rock AR 72205-3990 | |
| (501) 663-4357 | |
| (501) 663-4360 |
| Full Name | Baptist Health Family Clinic - Hillcrest |
|---|---|
| Speciality | Family Medicine |
| Location | 2601 Kavanaugh Blvd, Little Rock, Arkansas |
| Authorized Official Name and Position | Will Rusher (CFO) |
| Authorized Official Contact | 5018127587 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Baptist Health Family Clinic - Hillcrest 11001 Executive Center Dr Suite 200 Little Rock AR 72211-4316 Ph: (501) 812-7800 | Baptist Health Family Clinic - Hillcrest 2601 Kavanaugh Blvd Suite 6 Little Rock AR 72205-3990 Ph: (501) 663-4357 |
| NPI Number | 1285915629 |
|---|---|
| Provider Enumeration Date | 08/30/2011 |
| Last Update Date | 04/11/2019 |
| Medicare PECOS PAC ID | 7911802079 |
|---|---|
| Medicare Enrollment ID | O20111005000418 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285915629 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | (* (Not Available)) | Secondary |
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Stephanie G Cody |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1275632903 PECOS PAC ID: 4486679131 Enrollment ID: I20051011001104 |
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