| Endocrinology Of South Arkansas | |
|
7500 Dollarway Rd Suite 404 White Hall AR 71602-3027 | |
| (870) 879-9595 | |
| (870) 879-9599 |
| Full Name | Endocrinology Of South Arkansas |
|---|---|
| Speciality | Clinic/Center |
| Location | 7500 Dollarway Rd, White Hall, Arkansas |
| Authorized Official Name and Position | Walter Johnson (CEO) |
| Authorized Official Contact | 8705417269 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Endocrinology Of South Arkansas 7500 Dollarway Rd Suite 404 White Hall AR 71602-3027 Ph: (870) 879-9595 | Endocrinology Of South Arkansas 7500 Dollarway Rd Suite 404 White Hall AR 71602-3027 Ph: (870) 879-9595 |
| NPI Number | 1306097365 |
|---|---|
| Provider Enumeration Date | 10/08/2008 |
| Last Update Date | 01/21/2011 |
| Medicare PECOS PAC ID | 8123927431 |
|---|---|
| Medicare Enrollment ID | O20090106000067 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306097365 | NPI | - | NPPES |
| 176263002 | Medicaid | AR | |
| 5G130 | Other | AR | BLUE CROSS BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Maher Alesali |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1801901509 PECOS PAC ID: 7416010236 Enrollment ID: I20090106000088 |
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