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3162 W Martin Luther King Blvd Suites 13 & 14 Fayetteville AR 72704-7684 | |
(479) 935-4834 | |
(479) 751-2878 |
Full Name | |
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Speciality | Clinic/Center |
Location | 3162 W Martin Luther King Blvd, Fayetteville, Arkansas |
Authorized Official Name and Position | James Semingson (CEO) |
Authorized Official Contact | 4797517417 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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614 E Emma Ave Suite 300 Springdale AR 72764-4634 Ph: (479) 751-7417 | 3162 W Martin Luther King Blvd Suites 13 & 14 Fayetteville AR 72704-7684 Ph: (479) 935-4834 |
NPI Number | 1013384288 |
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Provider Enumeration Date | 08/24/2015 |
Last Update Date | 01/15/2020 |
Medicare PECOS PAC ID | 0042262495 |
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Medicare Enrollment ID | O20160114000131 |
Identifier | Type | State | Issuer |
---|---|---|---|
1013384288 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
K E Management Services Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1420 E Augustine Ln Ste 7, Fayetteville, AR 72703 Phone: 479-200-9812 Fax: 866-243-7203 | |
Arcare Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1792 E Joyce Blvd, Fayetteville, AR 72703 Phone: 501-500-5001 Fax: 501-500-5001 | |