| Betton Clinic | |
|
1505 W 11th St Little Rock AR 72202-4619 | |
| (501) 376-1160 | |
| (501) 376-3977 |
| Full Name | Betton Clinic |
|---|---|
| Speciality | Family Medicine |
| Location | 1505 W 11th St, Little Rock, Arkansas |
| Authorized Official Name and Position | Harold Byrd Betton (PRESIDENT) |
| Authorized Official Contact | 5013761160 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Betton Clinic 1505 W 11th St Little Rock AR 72202-4619 Ph: (501) 376-1160 | Betton Clinic 1505 W 11th St Little Rock AR 72202-4619 Ph: (501) 376-1160 |
| NPI Number | 1386673499 |
|---|---|
| Provider Enumeration Date | 07/01/2006 |
| Last Update Date | 11/07/2011 |
| Medicare PECOS PAC ID | 5698771368 |
|---|---|
| Medicare Enrollment ID | O20061020000158 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386673499 | NPI | - | NPPES |
| 104803002 | Medicaid | AR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | MC-0637 (Arkansas) | Primary |
| Provider Name | Harold B Betton |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1275528267 PECOS PAC ID: 5597761478 Enrollment ID: I20111017000038 |
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