| |
819 W Carpenter St Benton AR 72015-3349 | |
(501) 778-8264 | |
(501) 778-7360 |
Full Name | |
---|---|
Speciality | Family Medicine |
Location | 819 W Carpenter St, Benton, 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 |
---|---|
11001 Executive Center Dr Ste 200 Little Rock AR 72211-4393 Ph: (501) 812-7215 | 819 W Carpenter St Benton AR 72015-3349 Ph: (501) 778-8264 |
NPI Number | 1558330969 |
---|---|
Provider Enumeration Date | 03/16/2006 |
Last Update Date | 04/11/2019 |
Medicare PECOS PAC ID | 7911802079 |
---|---|
Medicare Enrollment ID | O20031216000744 |
Identifier | Type | State | Issuer |
---|---|---|---|
1558330969 | NPI | - | NPPES |
128269002 | Medicaid | AR |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | Cara B Ballard |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1457310476 PECOS PAC ID: 2961471776 Enrollment ID: I20040929000108 |
Provider Name | Michael Beard |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1316949167 PECOS PAC ID: 3779549225 Enrollment ID: I20041206001168 |
Provider Name | Mark A Vice |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1134188063 PECOS PAC ID: 3577512375 Enrollment ID: I20050119000631 |
Provider Name | Jeffrey Steven Mayfield |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1184697203 PECOS PAC ID: 0446204705 Enrollment ID: I20050323000632 |
Provider Name | Chrysti L Williams |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1992764518 PECOS PAC ID: 3476576604 Enrollment ID: I20060125000659 |
Provider Name | Timothy S Morse |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1811130867 PECOS PAC ID: 7618022120 Enrollment ID: I20090908000169 |
Provider Name | Hannah K Baugh |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1174057376 PECOS PAC ID: 3173894557 Enrollment ID: I20170803000028 |
Provider Name | Joseph A Koon |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1922687649 PECOS PAC ID: 7810397833 Enrollment ID: I20240628003498 |
Epoch Health- Benton, Pllc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5 Medical Park Dr, Benton, AR 72015 Phone: 877-321-8452 | |
Ascent Childrens Heath Services Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3214 Winchester Dr., Benton, AR 72015 Phone: 501-326-6160 Fax: 501-326-6161 | |
Congo Dental, Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2101 Congo Rd Ste C, Benton, AR 72015 Phone: 501-778-1400 Fax: 501-778-6194 | |
Saline Physician Services, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1 Medical Park Dr, Benton, AR 72015 Phone: 501-776-6010 | |