Decatur Medi Clinic | |
346 N. Main Street Decatur AR 72722-0735 | |
(479) 752-3232 | |
(479) 752-3235 |
Full Name | Decatur Medi Clinic |
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Speciality | Clinic/Center |
Location | 346 N. Main Street, Decatur, Arkansas |
Authorized Official Name and Position | Peggy A Beal (AUTHORIZED OFFICIAL) |
Authorized Official Contact | 4797523233 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Decatur Medi Clinic Po Box 735 Decatur AR 72722-0735 Ph: (479) 752-3233 | Decatur Medi Clinic 346 N. Main Street Decatur AR 72722-0735 Ph: (479) 752-3232 |
NPI Number | 1023028016 |
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Provider Enumeration Date | 08/09/2006 |
Last Update Date | 07/17/2024 |
Medicare PECOS PAC ID | 0345235222 |
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Medicare Enrollment ID | O20040419001555 |
Identifier | Type | State | Issuer |
---|---|---|---|
1023028016 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Provider Name | Jeff Paul Honderich |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1477511434 PECOS PAC ID: 8123912482 Enrollment ID: I20040623000645 |
Provider Name | Meghann R Whatley |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1134713027 PECOS PAC ID: 6305253733 Enrollment ID: I20210331000067 |
Sgoh Acquisition Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 346 N Main St, Decatur, AR 72722 Phone: 479-752-3233 Fax: 479-752-3235 |