| Lewallen & Felty Pllc | |
|
2210 W Kingshighway Ste 9 Paragould AR 72450-3987 | |
| (870) 926-5710 | |
| Not Available |
| Full Name | Lewallen & Felty Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 2210 W Kingshighway Ste 9, Paragould, Arkansas |
| Authorized Official Name and Position | Larry Lucas Lewallen (CEO) |
| Authorized Official Contact | 8709265710 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lewallen & Felty Pllc 611 County Road 763 Brookland AR 72417-8951 Ph: (870) 926-5710 | Lewallen & Felty Pllc 2210 W Kingshighway Ste 9 Paragould AR 72450-3987 Ph: (870) 926-5710 |
| NPI Number | 1659801769 |
|---|---|
| Provider Enumeration Date | 06/13/2017 |
| Last Update Date | 09/26/2017 |
| Medicare PECOS PAC ID | 4789959560 |
|---|---|
| Medicare Enrollment ID | O20171004001196 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659801769 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Tiffany L Felty |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1477720951 PECOS PAC ID: 5698800183 Enrollment ID: I20100323000555 |
| Provider Name | Larry L Lewallen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1437342268 PECOS PAC ID: 0042430175 Enrollment ID: I20141013000868 |
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