| |
2037 W Main St Cabot AR 72023-7479 | |
(501) 843-4555 | |
(501) 743-1550 |
Full Name | |
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Speciality | Family Medicine |
Location | 2037 W Main St, Cabot, Arkansas |
Authorized Official Name and Position | Judi Harvey (CLINIC MANAGER) |
Authorized Official Contact | 5018434555 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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2037 W Main St P.o. Box 1325 Cabot AR 72023-7479 Ph: (501) 843-4555 | 2037 W Main St Cabot AR 72023-7479 Ph: (501) 843-4555 |
NPI Number | 1881848257 |
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Provider Enumeration Date | 11/11/2008 |
Last Update Date | 12/12/2008 |
Medicare PECOS PAC ID | 8729142682 |
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Medicare Enrollment ID | O20090122000093 |
Identifier | Type | State | Issuer |
---|---|---|---|
1881848257 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
208000000X | Pediatrics | (* (Not Available)) | Secondary |
Provider Name | Jason A Merrick |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1578524435 PECOS PAC ID: 4981597606 Enrollment ID: I20040205001190 |
Provider Name | Susanne L Lassieur Robertson |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1578520227 PECOS PAC ID: 2860475670 Enrollment ID: I20040611000891 |
Provider Name | Jeffrey D Stamp |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1023079985 PECOS PAC ID: 6709860232 Enrollment ID: I20040614001205 |
Provider Name | Joseph F Shotts |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1194786111 PECOS PAC ID: 0446314306 Enrollment ID: I20090209000026 |
Provider Name | Ruth A Blair |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1669433520 PECOS PAC ID: 6800950767 Enrollment ID: I20090209000027 |
Provider Name | Julian Hernandez |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1396935466 PECOS PAC ID: 6406900927 Enrollment ID: I20090819000022 |
Provider Name | Joseph B Mccutcheon |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1326572934 PECOS PAC ID: 9931441540 Enrollment ID: I20190501001599 |
Provider Name | James Blake Holloway |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1194288662 PECOS PAC ID: 9032452776 Enrollment ID: I20220714002852 |
Provider Name | Dustin L Walter |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1295295806 PECOS PAC ID: 9931434222 Enrollment ID: I20230803000073 |
Provider Name | Joyce N Kuykendall |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1902483969 PECOS PAC ID: 4789091877 Enrollment ID: I20240912001769 |
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 | |