| |
906 S Pine St Ste 5 Cabot AR 72023-3837 | |
(501) 422-6700 | |
(501) 422-6710 |
Full Name | |
---|---|
Speciality | Family Medicine |
Location | 906 S Pine St Ste 5, Cabot, Arkansas |
Authorized Official Name and Position | Kimberly Macconaugha (PEDIATRIC NURSE PRACTITIONER/OWNER) |
Authorized Official Contact | 5014226700 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
906 S Pine St Ste 5 Cabot AR 72023-3837 Ph: () - | 906 S Pine St Ste 5 Cabot AR 72023-3837 Ph: (501) 422-6700 |
NPI Number | 1629754320 |
---|---|
Provider Enumeration Date | 06/26/2023 |
Last Update Date | 06/29/2023 |
Medicare PECOS PAC ID | 8628416948 |
---|---|
Medicare Enrollment ID | O20240405001864 |
Identifier | Type | State | Issuer |
---|---|---|---|
1629754320 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | Soren C Louvring |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1154582799 PECOS PAC ID: 8527107747 Enrollment ID: I20091201000714 |
Provider Name | James Stewart Reeves |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1699040618 PECOS PAC ID: 6103065891 Enrollment ID: I20130826000388 |
Provider Name | Kimberly Macconaugha |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1851653117 PECOS PAC ID: 1052676988 Enrollment ID: I20180524001794 |
Provider Name | Chelsea Nicole Hawley |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1801570403 PECOS PAC ID: 9931568946 Enrollment ID: I20230710001353 |
Jerry L Harvey, Do, Pa Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 15361 Highway 5, Suite E, Cabot, AR 72023 Phone: 501-605-9355 | |