| Central Medical Group | |
|
1 Saint Vincent Cir Suite 350 Little Rock AR 72205-5405 | |
| (501) 664-5932 | |
| (501) 296-9008 |
| Full Name | Central Medical Group |
|---|---|
| Speciality | Internal Medicine |
| Location | 1 Saint Vincent Cir, Little Rock, Arkansas |
| Authorized Official Name and Position | Gloria Dean Love (OFFICE ADMINISTRATOR/MANAGER) |
| Authorized Official Contact | 5016645932 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Central Medical Group 1 Saint Vincent Cir Suite 350 Little Rock AR 72205-5405 Ph: (501) 664-5932 | Central Medical Group 1 Saint Vincent Cir Suite 350 Little Rock AR 72205-5405 Ph: (501) 664-5932 |
| NPI Number | 1205895232 |
|---|---|
| Provider Enumeration Date | 03/20/2006 |
| Last Update Date | 02/11/2008 |
| Medicare PECOS PAC ID | 4486744869 |
|---|---|
| Medicare Enrollment ID | O20071221000458 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205895232 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | C4841 (Arkansas) | Secondary |
| 207R00000X | Internal Medicine | C6406 (Arkansas) | Primary |
| Provider Name | Tommy Love |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1689681355 PECOS PAC ID: 3678663051 Enrollment ID: I20071221000450 |
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