| East Arkansas Family Health Center Inc. | |
|
102 West Broad Lepanto AR 72354 | |
| (870) 475-2977 | |
| (870) 475-3440 |
| Full Name | East Arkansas Family Health Center Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 102 West Broad, Lepanto, Arkansas |
| Authorized Official Name and Position | Susan E Ward-jones (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 8707353842 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| East Arkansas Family Health Center Inc. 900 N 7th St West Memphis AR 72301-2001 Ph: (870) 735-3842 | East Arkansas Family Health Center Inc. 102 West Broad Lepanto AR 72354 Ph: (870) 475-2977 |
| NPI Number | 1922139062 |
|---|---|
| Provider Enumeration Date | 03/08/2007 |
| Last Update Date | 11/18/2020 |
| Medicare PECOS PAC ID | 1052390390 |
|---|---|
| Medicare Enrollment ID | O20080614000123 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922139062 | NPI | - | NPPES |
| 122837749 | Medicaid | AR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QC1500X | Clinic/center - Community Health | (* (Not Available)) | Secondary |
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
| Provider Name | Holli Banks-giles |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1689644478 PECOS PAC ID: 9335103142 Enrollment ID: I20041111001118 |
| Provider Name | Patricia A Devine |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1396762977 PECOS PAC ID: 7315013232 Enrollment ID: I20080829000105 |
| Provider Name | Susan Ward Jones |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1851368740 PECOS PAC ID: 0941384663 Enrollment ID: I20091006000096 |
| Provider Name | Valerie D Woodruff |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558594424 PECOS PAC ID: 4284774118 Enrollment ID: I20091228000041 |
| Provider Name | Valencia M Andrews-pirtle |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1255318093 PECOS PAC ID: 9830381193 Enrollment ID: I20101006000126 |
| Provider Name | Kristi R Allen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114994035 PECOS PAC ID: 4981890571 Enrollment ID: I20101122000676 |
| Provider Name | Ellen Lee Speak |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285819227 PECOS PAC ID: 6901824093 Enrollment ID: I20110228000150 |
| Provider Name | Tanja L Mead |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902903636 PECOS PAC ID: 9739115221 Enrollment ID: I20110805000467 |
| Provider Name | Geral D Towne |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295140374 PECOS PAC ID: 7517185598 Enrollment ID: I20140904002307 |
| Provider Name | Djuana Smith |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1376854273 PECOS PAC ID: 6608195367 Enrollment ID: I20150430000337 |
| Provider Name | Lakisha A Mcdaniel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326392671 PECOS PAC ID: 1153573514 Enrollment ID: I20151104000297 |
| Provider Name | Ebony Lewis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427447564 PECOS PAC ID: 7810264132 Enrollment ID: I20170517000265 |
| Provider Name | Ursula Desha Logan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760915813 PECOS PAC ID: 0648599936 Enrollment ID: I20170905002809 |
| Provider Name | Lindsey Morgan Bryan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518443670 PECOS PAC ID: 0648528638 Enrollment ID: I20180808000589 |
| Provider Name | Tameka L Smith-granberry |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1619348703 PECOS PAC ID: 3779827969 Enrollment ID: I20181128002491 |
| Provider Name | Nikita Coleman-smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184197501 PECOS PAC ID: 5193063808 Enrollment ID: I20190205000577 |
| Provider Name | Phyllis Thompson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952808651 PECOS PAC ID: 5597005397 Enrollment ID: I20190313002821 |
| Provider Name | Adrienne D Hatchett |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1760838833 PECOS PAC ID: 2062747983 Enrollment ID: I20190716000250 |
| Provider Name | Felica Shunta Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881256220 PECOS PAC ID: 4183953367 Enrollment ID: I20190913000328 |
| Provider Name | Celena Lanette Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205499019 PECOS PAC ID: 8426382961 Enrollment ID: I20191031000899 |
| Provider Name | Cecelia Hooks |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1578633780 PECOS PAC ID: 1355753930 Enrollment ID: I20201228000139 |
| Provider Name | Aleshia G Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407463938 PECOS PAC ID: 3577977123 Enrollment ID: I20210122001396 |
| Provider Name | Cynthia Joyce Robinson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982230421 PECOS PAC ID: 9133521602 Enrollment ID: I20210707002205 |
| Provider Name | Racheal Mitchell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689021834 PECOS PAC ID: 0749572287 Enrollment ID: I20210713000236 |
Wagner Medical Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 331 Broad Street, Suite B, Lepanto, AR 72354 Phone: 870-475-3825 Fax: 870-475-3823 | |
Family Medical Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 260 West Broad Street, Lepanto, AR 72354 Phone: 870-475-3180 Fax: 870-475-3185 |