| Hcc Of Fordyce, Llc | |
|
201 N Clifton St Fordyce AR 71742-3026 | |
| (870) 352-6300 | |
| Not Available |
| Full Name | Hcc Of Fordyce, Llc |
|---|---|
| Speciality | Hospitalist |
| Location | 201 N Clifton St, Fordyce, Arkansas |
| Authorized Official Name and Position | Ron Weiss (CEO) |
| Authorized Official Contact | 8669318882 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Hcc Of Fordyce, Llc 17304 Preston Rd Suite 1400 Dallas TX 75252-5618 Ph: (866) 931-8882 | Hcc Of Fordyce, Llc 201 N Clifton St Fordyce AR 71742-3026 Ph: (870) 352-6300 |
| NPI Number | 1316497464 |
|---|---|
| Provider Enumeration Date | 10/12/2016 |
| Last Update Date | 10/02/2019 |
| Medicare PECOS PAC ID | 5395024475 |
|---|---|
| Medicare Enrollment ID | O20161112000042 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316497464 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
| 208M00000X | Hospitalist | (* (Not Available)) | Primary |
| Provider Name | William Coleman Kent |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1316943632 PECOS PAC ID: 7214849967 Enrollment ID: I20031103000189 |
| Provider Name | Sahibzada A Ahmed |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1285631473 PECOS PAC ID: 6901793306 Enrollment ID: I20040301001085 |
| Provider Name | M Jeanine Trevillyan |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1801958145 PECOS PAC ID: 1153318217 Enrollment ID: I20040429000719 |
| Provider Name | David J Foscue |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1366409930 PECOS PAC ID: 6002806353 Enrollment ID: I20040621001825 |
| Provider Name | Rodney M Dixon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1174508386 PECOS PAC ID: 9739164682 Enrollment ID: I20040623001020 |
| Provider Name | Madhulika Krish |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538168505 PECOS PAC ID: 5395722599 Enrollment ID: I20040706001014 |
| Provider Name | Carolyn E Vogler |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1215968599 PECOS PAC ID: 1658351747 Enrollment ID: I20040721000013 |
| Provider Name | Raymond P Hartman |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1811976509 PECOS PAC ID: 7113988031 Enrollment ID: I20041025000302 |
| Provider Name | Lloyd E Ruff |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1972530921 PECOS PAC ID: 8527005644 Enrollment ID: I20050411000885 |
| Provider Name | Jeff M Audibert |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1407801723 PECOS PAC ID: 9234178252 Enrollment ID: I20050428001140 |
| Provider Name | James Foster Beck |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1114955085 PECOS PAC ID: 3870405475 Enrollment ID: I20050714000375 |
| Provider Name | Roderick R Boyd |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1295754075 PECOS PAC ID: 6800881210 Enrollment ID: I20050810000592 |
| Provider Name | Remel D Buslig |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1548291420 PECOS PAC ID: 0244256881 Enrollment ID: I20051021000782 |
| Provider Name | William S Lynn |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1588682785 PECOS PAC ID: 0648294249 Enrollment ID: I20060123000502 |
| Provider Name | Steven M Erwin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1699733741 PECOS PAC ID: 9931110715 Enrollment ID: I20060508000720 |
| Provider Name | James R Landry |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1306868674 PECOS PAC ID: 2567469984 Enrollment ID: I20061027000271 |
| Provider Name | Salman Hashmi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427150036 PECOS PAC ID: 8628171899 Enrollment ID: I20070307000634 |
| Provider Name | Larry D. Ezell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1679523807 PECOS PAC ID: 8729170451 Enrollment ID: I20070824000670 |
| Provider Name | Jabbar Abdul Joshua |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1164556460 PECOS PAC ID: 9234223231 Enrollment ID: I20070928000632 |
| Provider Name | Lindsey N Walley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1851470140 PECOS PAC ID: 0143304436 Enrollment ID: I20080226000220 |
| Provider Name | Jeremy W Saul |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437350600 PECOS PAC ID: 0648357111 Enrollment ID: I20080408000455 |
| Provider Name | Ashraf M Diab |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1902072077 PECOS PAC ID: 1456428713 Enrollment ID: I20080929000323 |
| Provider Name | Nasir Zareen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1972709418 PECOS PAC ID: 7113071812 Enrollment ID: I20091013000328 |
| Provider Name | Restituto S Ruiz |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1215922661 PECOS PAC ID: 4981503547 Enrollment ID: I20100730000593 |
| Provider Name | Tracy Thomas Phillips |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1679571863 PECOS PAC ID: 2163555319 Enrollment ID: I20100809000688 |
| Provider Name | Kenyetta Gordon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1013101161 PECOS PAC ID: 3870786676 Enrollment ID: I20101026000025 |
| Provider Name | Karla R Jones-montgomery |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700893690 PECOS PAC ID: 7911191754 Enrollment ID: I20101105000019 |
| Provider Name | Joshua A Motes |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1619105277 PECOS PAC ID: 5092900977 Enrollment ID: I20101117001135 |
| Provider Name | Egbert F Rebeiro |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1275583908 PECOS PAC ID: 0547225518 Enrollment ID: I20110920000510 |
| Provider Name | Abrar Ashraf Khan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578976908 PECOS PAC ID: 9739499534 Enrollment ID: I20151106001334 |
| Provider Name | Jaron F Byrd |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578881488 PECOS PAC ID: 0446560080 Enrollment ID: I20151110002099 |
| Provider Name | Jermey R Jones |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235542739 PECOS PAC ID: 6103136668 Enrollment ID: I20151112001928 |
| Provider Name | Hamida Saba |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1710390158 PECOS PAC ID: 7719282425 Enrollment ID: I20160217002082 |
| Provider Name | Samuel Turner |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1306224068 PECOS PAC ID: 3072801513 Enrollment ID: I20161015000213 |
| Provider Name | Wallace Lock |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437545761 PECOS PAC ID: 8527373398 Enrollment ID: I20161025000574 |
| Provider Name | William M Barr |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1811061450 PECOS PAC ID: 6406032374 Enrollment ID: I20161028001626 |
| Provider Name | Joshua A Tennyson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1588042246 PECOS PAC ID: 3577843853 Enrollment ID: I20161201002339 |
| Provider Name | Teresa Bau |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1699153338 PECOS PAC ID: 8123308160 Enrollment ID: I20161208000181 |
| Provider Name | Stewart Rowell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528446283 PECOS PAC ID: 0749560696 Enrollment ID: I20161210000104 |
| Provider Name | Payal Patel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912385667 PECOS PAC ID: 1456633502 Enrollment ID: I20170125000178 |
| Provider Name | Peter Sidarous |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881072544 PECOS PAC ID: 8123302486 Enrollment ID: I20170306000271 |
| Provider Name | Ghulam Khan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1588042220 PECOS PAC ID: 0648557686 Enrollment ID: I20170501001318 |
| Provider Name | Eliyahu Hemo |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1255627824 PECOS PAC ID: 7517277627 Enrollment ID: I20170819000026 |
| Provider Name | Nathan Probst |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1508213984 PECOS PAC ID: 8527333251 Enrollment ID: I20171006000074 |
| Provider Name | Mai Abd Alqader |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487001848 PECOS PAC ID: 0749556959 Enrollment ID: I20171016001976 |
| Provider Name | Christopher Mcdaniel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700299138 PECOS PAC ID: 3274899406 Enrollment ID: I20171103002265 |
| Provider Name | Bhargav Sai Charan Marthambadi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1124475595 PECOS PAC ID: 5193081784 Enrollment ID: I20171115001113 |
| Provider Name | Jonathan Kenton Tackett |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1407203888 PECOS PAC ID: 0042578130 Enrollment ID: I20171219001258 |
| Provider Name | Maria E Montales |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1265889638 PECOS PAC ID: 3476813221 Enrollment ID: I20180216000118 |
| Provider Name | Josiah Onyenekwe |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558781740 PECOS PAC ID: 3476877184 Enrollment ID: I20180219002010 |
| Provider Name | Samuel T Burns |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1922428077 PECOS PAC ID: 1254653595 Enrollment ID: I20180628002722 |
| Provider Name | Seyedeh Maryam Bashiri |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1477900850 PECOS PAC ID: 6305195439 Enrollment ID: I20180822001222 |
| Provider Name | Bao Pham |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497134696 PECOS PAC ID: 4183914559 Enrollment ID: I20180906003134 |
| Provider Name | John P Cooper |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1366973786 PECOS PAC ID: 2163794207 Enrollment ID: I20181010001248 |
| Provider Name | Mohanned H Ahmed |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1053725499 PECOS PAC ID: 0345539680 Enrollment ID: I20181108001977 |
| Provider Name | Chadwick W Gaddis |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1912295411 PECOS PAC ID: 3072822139 Enrollment ID: I20181213000989 |
| Provider Name | Bruce M Doxey |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1356606917 PECOS PAC ID: 5597065946 Enrollment ID: I20181219003274 |
| Provider Name | Emmanuel Obi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447791645 PECOS PAC ID: 3678840824 Enrollment ID: I20190508000049 |
| Provider Name | Mohammed Malik |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1760916365 PECOS PAC ID: 0840533972 Enrollment ID: I20190513002195 |
| Provider Name | Larry T Robins |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1982135000 PECOS PAC ID: 0648547042 Enrollment ID: I20190517000163 |
| Provider Name | Sifau Oladipo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1336675123 PECOS PAC ID: 9739454497 Enrollment ID: I20190812003044 |
| Provider Name | Derek Means |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740771013 PECOS PAC ID: 5294082467 Enrollment ID: I20191023000530 |
| Provider Name | Fabian Oechsle |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1972094225 PECOS PAC ID: 2860748498 Enrollment ID: I20191023002846 |
| Provider Name | Candice Valmont |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1598256497 PECOS PAC ID: 7810229697 Enrollment ID: I20191028002444 |
| Provider Name | Elizabeth Eoff |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1851827679 PECOS PAC ID: 9739454489 Enrollment ID: I20191105001508 |
| Provider Name | Marjorie Hudson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538697438 PECOS PAC ID: 9537593173 Enrollment ID: I20200107001752 |
| Provider Name | Brett Monroe |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497246086 PECOS PAC ID: 7113353632 Enrollment ID: I20200131001813 |
| Provider Name | Jheanelle N Dawkins |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1811494974 PECOS PAC ID: 9436585981 Enrollment ID: I20200203000237 |
| Provider Name | Obioma Nwaiwu |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1649634601 PECOS PAC ID: 8426340357 Enrollment ID: I20200730000626 |
| Provider Name | Ewane Ngone |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770554446 PECOS PAC ID: 9830094853 Enrollment ID: I20201013002731 |
| Provider Name | Jack Zepeda |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1184192510 PECOS PAC ID: 9133454408 Enrollment ID: I20210211000906 |
| Provider Name | Karine Sensiba |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1912567231 PECOS PAC ID: 9032449509 Enrollment ID: I20210318000700 |
| Provider Name | Ian Valmont |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1780175257 PECOS PAC ID: 7416203054 Enrollment ID: I20210421001774 |
| Provider Name | Madeline Sparling |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154981710 PECOS PAC ID: 1254662885 Enrollment ID: I20210708001348 |
| Provider Name | Shama Khan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1083174502 PECOS PAC ID: 0042615585 Enrollment ID: I20210823001198 |
| Provider Name | Sania Sayani |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528528809 PECOS PAC ID: 1658778105 Enrollment ID: I20210925000186 |
| Provider Name | Nastasya Mae Jabaly |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1043773237 PECOS PAC ID: 1355684127 Enrollment ID: I20211007001115 |
| Provider Name | Hagop Jack Keleshian |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1326381468 PECOS PAC ID: 4486923570 Enrollment ID: I20211105001345 |
| Provider Name | Amber L Jackson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770105967 PECOS PAC ID: 3678990777 Enrollment ID: I20220525002273 |
| Provider Name | Amelia Ramzan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1326667718 PECOS PAC ID: 5799108114 Enrollment ID: I20220622003412 |
| Provider Name | Olufadejimi Kareem |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1639790983 PECOS PAC ID: 6406273945 Enrollment ID: I20220706000678 |
| Provider Name | Mary Zhang |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1144797101 PECOS PAC ID: 3971984584 Enrollment ID: I20220713003495 |
| Provider Name | Muhammad Ahzam |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1891315008 PECOS PAC ID: 8527480177 Enrollment ID: I20220727001794 |
| Provider Name | Tracey A Lockhart Wright |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1104446103 PECOS PAC ID: 7113309691 Enrollment ID: I20220730000032 |
| Provider Name | Ali Rafatnia |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346878717 PECOS PAC ID: 2668893009 Enrollment ID: I20220802003243 |
| Provider Name | Nesly Dorcely |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1417585845 PECOS PAC ID: 1254753668 Enrollment ID: I20220803001164 |
| Provider Name | Ross T Lenzen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497376453 PECOS PAC ID: 1254741705 Enrollment ID: I20220803003566 |
| Provider Name | Jennifer Terry |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1952923518 PECOS PAC ID: 7719397959 Enrollment ID: I20220809000835 |
| Provider Name | Raquel Rivera Cruz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1649700337 PECOS PAC ID: 7012268501 Enrollment ID: I20220901003433 |
| Provider Name | Sree Chellappan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073133179 PECOS PAC ID: 3779968276 Enrollment ID: I20220920001817 |
| Provider Name | Khaled Hassan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1144807694 PECOS PAC ID: 6709262116 Enrollment ID: I20221007000264 |
| Provider Name | Jackson Haynes |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1255918157 PECOS PAC ID: 9234515669 Enrollment ID: I20221007001309 |
| Provider Name | Chizoba Usuwa |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689191108 PECOS PAC ID: 3476929894 Enrollment ID: I20221026000701 |
| Provider Name | Shawn M Anderson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1598725111 PECOS PAC ID: 7517989106 Enrollment ID: I20221109003311 |
| Provider Name | Rebecca M Broadbent |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578183653 PECOS PAC ID: 4183092794 Enrollment ID: I20221201000715 |
| Provider Name | Primus I Mbawuike |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1487008793 PECOS PAC ID: 4082083118 Enrollment ID: I20221213001934 |
| Provider Name | Deepak Goyal |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1891373379 PECOS PAC ID: 3072982925 Enrollment ID: I20221215001050 |
| Provider Name | Renee Frederick |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497381503 PECOS PAC ID: 4688045636 Enrollment ID: I20230130002065 |
| Provider Name | Clint Cox |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1760062921 PECOS PAC ID: 0941682744 Enrollment ID: I20230207003662 |
| Provider Name | Anum Rasheed |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1194285478 PECOS PAC ID: 3476927344 Enrollment ID: I20230315001946 |
| Provider Name | Rosario Karl Guastella |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1538746441 PECOS PAC ID: 4183098007 Enrollment ID: I20230316000422 |
| Provider Name | Vaibhav S Desai |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922627249 PECOS PAC ID: 9436571833 Enrollment ID: I20230328002057 |
| Provider Name | Grace Browne |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1568959674 PECOS PAC ID: 2961829031 Enrollment ID: I20230329000002 |
| Provider Name | Sarah K Kabemba Tshitenge |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154959211 PECOS PAC ID: 5395167514 Enrollment ID: I20230329002278 |
| Provider Name | Michael Hughes |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1942662820 PECOS PAC ID: 1951608116 Enrollment ID: I20230721003494 |
| Provider Name | Rayan Lungba |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1972180438 PECOS PAC ID: 2769846989 Enrollment ID: I20230906003713 |
| Provider Name | Clinton Alexander Akin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730766627 PECOS PAC ID: 0446604243 Enrollment ID: I20230927004030 |
| Provider Name | Tyler Welch |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1255958484 PECOS PAC ID: 4789092065 Enrollment ID: I20231025000020 |
| Provider Name | Ndidi Jessica Udeogu |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1588241269 PECOS PAC ID: 5597174060 Enrollment ID: I20231205001261 |
| Provider Name | Samuel Edward Ward |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1982661757 PECOS PAC ID: 2062401169 Enrollment ID: I20231205004049 |
| Provider Name | Omar Alazzawi |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1346816444 PECOS PAC ID: 0345691069 Enrollment ID: I20240108000744 |
Michael D Payne Md Pllc Pa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 200 N Clifton St, Fordyce, AR 71742 Phone: 870-352-3151 Fax: 870-352-8497 | |
Rodney Mark Dixon Md Pa Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 201 N Clifton St, Fordyce, AR 71742 Phone: 870-352-6300 | |
Nutt-walley Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 110 N Clifton St, Fordyce, AR 71742 Phone: 870-352-3525 Fax: 870-352-3533 | |
Dallas County Medical Center Family Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 201 North Clifton Street, Fordyce, AR 71742 Phone: 870-352-6363 Fax: 870-352-6343 | |
Hugh A. Nutt M.d. P.a. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 110 N Clifton St, Fordyce, AR 71742 Phone: 870-352-5144 Fax: 870-352-8498 | |
Nutt-walley Clinic Of Dallas County Medical Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 110 N Clifton St, Fordyce, AR 71742 Phone: 870-352-3525 Fax: 870-352-3533 |