| Doctors Health Group, Inc | |
|
700 W Keiser Ave Osceola AR 72370-3506 | |
| (870) 563-0757 | |
| (870) 563-0754 |
| Full Name | Doctors Health Group, Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 700 W Keiser Ave, Osceola, Arkansas |
| Authorized Official Name and Position | John Lieblong (PRESIDENT) |
| Authorized Official Contact | 8709327024 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Doctors Health Group, Inc Po Box 1331 Jonesboro AR 72403-1331 Ph: (870) 932-7024 | Doctors Health Group, Inc 700 W Keiser Ave Osceola AR 72370-3506 Ph: (870) 563-0757 |
| NPI Number | 1851867071 |
|---|---|
| Provider Enumeration Date | 10/15/2018 |
| Last Update Date | 10/15/2018 |
| Medicare PECOS PAC ID | 7315844586 |
|---|---|
| Medicare Enrollment ID | O20190104000637 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851867071 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Sumner R Cullom |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1902885015 PECOS PAC ID: 4385556364 Enrollment ID: I20051102000768 |
| Provider Name | Lisa Jo Booker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053528778 PECOS PAC ID: 5597677013 Enrollment ID: I20141111000477 |
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