| Cornerstone Medical Clinic Pllc | |
|
825 N Main St. Harrison AR 72601 | |
| (870) 743-4900 | |
| (870) 743-4949 |
| Full Name | Cornerstone Medical Clinic Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 825 N Main St., Harrison, Arkansas |
| Authorized Official Name and Position | Steven M Shrum (OWNER) |
| Authorized Official Contact | 8707434900 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cornerstone Medical Clinic Pllc 825 N Main St. Harrison AR 72601 Ph: (870) 743-4900 | Cornerstone Medical Clinic Pllc 825 N Main St. Harrison AR 72601 Ph: (870) 743-4900 |
| NPI Number | 1063464964 |
|---|---|
| Provider Enumeration Date | 05/17/2006 |
| Last Update Date | 08/05/2020 |
| Medicare PECOS PAC ID | 2264461102 |
|---|---|
| Medicare Enrollment ID | O20050810000900 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063464964 | NPI | - | NPPES |
| 149189002 | Medicaid | AR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | MC2227 (Arkansas) | Primary |
| Provider Name | Steven Mark Shrum |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1669430286 PECOS PAC ID: 8224013040 Enrollment ID: I20040623001623 |
| Provider Name | Desiree Ann Looper |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225658149 PECOS PAC ID: 5890126999 Enrollment ID: I20200505001182 |
| Provider Name | Leslie Brooke Kimes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730803164 PECOS PAC ID: 6204202112 Enrollment ID: I20221018002132 |
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