| Tds Psychiatric Services L.l.c. | |
|
214 E Washington Ave Jonesboro AR 72401-3102 | |
| (870) 378-6521 | |
| Not Available |
| Full Name | Tds Psychiatric Services L.l.c. |
|---|---|
| Speciality | Clinic/Center |
| Location | 214 E Washington Ave, Jonesboro, Arkansas |
| Authorized Official Name and Position | Tiffany Spargo (APRN) |
| Authorized Official Contact | 8703786521 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tds Psychiatric Services L.l.c. 78 Endicott Trl Pocahontas AR 72455-8624 Ph: (870) 378-6521 | Tds Psychiatric Services L.l.c. 214 E Washington Ave Jonesboro AR 72401-3102 Ph: (870) 378-6521 |
| NPI Number | 1992289151 |
|---|---|
| Provider Enumeration Date | 09/23/2018 |
| Last Update Date | 09/23/2018 |
| Medicare PECOS PAC ID | 0547513319 |
|---|---|
| Medicare Enrollment ID | O20181024000854 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992289151 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
| Provider Name | Tiffany Spargo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073099198 PECOS PAC ID: 1456604222 Enrollment ID: I20181024000904 |
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