| Baptist Health Family Clinic Malvern | |
|
1234 S Main St Malvern AR 72104-5226 | |
| (501) 337-9066 | |
| (501) 332-5265 |
| Full Name | Baptist Health Family Clinic Malvern |
|---|---|
| Speciality | Family Medicine |
| Location | 1234 S Main St, Malvern, Arkansas |
| Authorized Official Name and Position | Will L Rusher (CEO) |
| Authorized Official Contact | 5018127500 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Baptist Health Family Clinic Malvern 11001 Executive Center Dr Ste 200 Little Rock AR 72211-4393 Ph: (501) 812-7800 | Baptist Health Family Clinic Malvern 1234 S Main St Malvern AR 72104-5226 Ph: (501) 337-9066 |
| NPI Number | 1356319511 |
|---|---|
| Provider Enumeration Date | 03/14/2006 |
| Last Update Date | 04/11/2019 |
| Medicare PECOS PAC ID | 7911802079 |
|---|---|
| Medicare Enrollment ID | O20080308000125 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356319511 | NPI | - | NPPES |
| 5183071 | Other | AR | AETNA |
| 128273002 | Medicaid | AR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Erin M Holleman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801021696 PECOS PAC ID: 5395899884 Enrollment ID: I20090818000596 |
| Provider Name | Misty A Douthit |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790914927 PECOS PAC ID: 0840345179 Enrollment ID: I20090909000736 |
| Provider Name | Altimus R Bollen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1720054125 PECOS PAC ID: 5597845404 Enrollment ID: I20100512001017 |
| Provider Name | Heather D Grigsby |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881002756 PECOS PAC ID: 6305065046 Enrollment ID: I20140911001883 |
| Provider Name | Richard B Chastain |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1104265081 PECOS PAC ID: 6103149612 Enrollment ID: I20150107002405 |
| Provider Name | Laura L Lester |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1568801447 PECOS PAC ID: 8224355326 Enrollment ID: I20150331000332 |
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Healthstar Physicians Of Hot Springs, Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1517 S Main St, Malvern, AR 72104 Phone: 501-332-7525 | |
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Healthy Connections, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1003 Schneider Dr, Malvern, AR 72104 Phone: 479-437-3449 Fax: 479-243-0285 |