| Cr Doc,pllc | |
|
2700 W Kingshighway Suite 4 Paragould AR 72450-2601 | |
| (870) 239-3600 | |
| (870) 240-0643 |
| Full Name | Cr Doc,pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 2700 W Kingshighway, Paragould, Arkansas |
| Authorized Official Name and Position | Roger Earl Cagle (OWNER) |
| Authorized Official Contact | 8702393600 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cr Doc,pllc 2700 W Kingshighway Suite 4 Paragould AR 72450-2601 Ph: (870) 239-3600 | Cr Doc,pllc 2700 W Kingshighway Suite 4 Paragould AR 72450-2601 Ph: (870) 239-3600 |
| NPI Number | 1285777029 |
|---|---|
| Provider Enumeration Date | 02/14/2007 |
| Last Update Date | 05/20/2014 |
| Medicare PECOS PAC ID | 0840190757 |
|---|---|
| Medicare Enrollment ID | O20040108001069 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285777029 | NPI | - | NPPES |
| 5C936 | Other | AR | ABCBS PROVIDER NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | C5380 (Arkansas) | Primary |
| Provider Name | Roger E Cagle |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1134282999 PECOS PAC ID: 3375443294 Enrollment ID: I20040204000786 |
| Provider Name | Toni T Garner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598013815 PECOS PAC ID: 0547405748 Enrollment ID: I20130316000001 |
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