| Antoonmedicalclinic,pa | |
|
218 Church St Stamps AR 71860-2816 | |
| (870) 533-1300 | |
| (870) 533-1303 |
| Full Name | Antoonmedicalclinic,pa |
|---|---|
| Speciality | Clinic/Center |
| Location | 218 Church St, Stamps, Arkansas |
| Authorized Official Name and Position | Patrick David Antoon (OWNER/PRESIDENT) |
| Authorized Official Contact | 8705331300 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Antoonmedicalclinic,pa 218 Church St Stamps AR 71860-2816 Ph: (870) 533-1300 | Antoonmedicalclinic,pa 218 Church St Stamps AR 71860-2816 Ph: (870) 533-1300 |
| NPI Number | 1073916383 |
|---|---|
| Provider Enumeration Date | 09/30/2014 |
| Last Update Date | 09/30/2014 |
| Medicare PECOS PAC ID | 2062736721 |
|---|---|
| Medicare Enrollment ID | O20180206001760 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073916383 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | R3556 (Arkansas) | Primary |
| Provider Name | Patrick David Antoon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1891090262 PECOS PAC ID: 9830165679 Enrollment ID: I20150129000507 |
| Provider Name | Claude W Wells |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801240395 PECOS PAC ID: 5991043184 Enrollment ID: I20190213002571 |
Harrison Family Medicine Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 218 Church St, Stamps, AR 71860 Phone: 870-533-1300 Fax: 870-533-1303 |