| Hometown Doc, Pa | |
|
1014 N Spring St Harrison AR 72601-2918 | |
| (870) 399-0077 | |
| (833) 607-6390 |
| Full Name | Hometown Doc, Pa |
|---|---|
| Speciality | Family Medicine |
| Location | 1014 N Spring St, Harrison, Arkansas |
| Authorized Official Name and Position | Thomas A. Langston (PRESIDENT/INCORPORATOR) |
| Authorized Official Contact | 8703990077 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Hometown Doc, Pa 1014 N Spring St Harrison AR 72601-2918 Ph: (870) 399-0077 | Hometown Doc, Pa 1014 N Spring St Harrison AR 72601-2918 Ph: (870) 399-0077 |
| NPI Number | 1568941433 |
|---|---|
| Provider Enumeration Date | 08/10/2018 |
| Last Update Date | 07/23/2020 |
| Medicare PECOS PAC ID | 9335493808 |
|---|---|
| Medicare Enrollment ID | O20181120000699 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568941433 | NPI | - | NPPES |
| 113835001 | Medicaid | AR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | C7305 (Arkansas) | Primary |
| Provider Name | Thomas A Langston |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1720086952 PECOS PAC ID: 4688868268 Enrollment ID: I20101104000518 |
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