| Hope Medical Clinic Inc | |
|
145 Shake Rag Rd Clinton AR 72031-6682 | |
| (501) 745-7161 | |
| (501) 745-8714 |
| Full Name | Hope Medical Clinic Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 145 Shake Rag Rd, Clinton, Arkansas |
| Authorized Official Name and Position | Stefanie Shaver (OFFICE MANAGER) |
| Authorized Official Contact | 5017457161 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Hope Medical Clinic Inc 145 Shake Rag Rd Clinton AR 72031-6682 Ph: (501) 745-7161 | Hope Medical Clinic Inc 145 Shake Rag Rd Clinton AR 72031-6682 Ph: (501) 745-7161 |
| NPI Number | 1013245471 |
|---|---|
| Provider Enumeration Date | 11/24/2009 |
| Last Update Date | 09/22/2014 |
| Medicare PECOS PAC ID | 9739223462 |
|---|---|
| Medicare Enrollment ID | O20100219000056 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013245471 | NPI | - | NPPES |
| 185295729 | Medicaid | AR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
| Provider Name | Nichole D Clark |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548464936 PECOS PAC ID: 5597797506 Enrollment ID: I20100219000050 |
| Provider Name | Dana S Treat |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871808048 PECOS PAC ID: 0143400416 Enrollment ID: I20110204000035 |
| Provider Name | Jordan B Kendrick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841564895 PECOS PAC ID: 0648416560 Enrollment ID: I20130422000083 |
| Provider Name | Richard C Melin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1174524086 PECOS PAC ID: 8527971886 Enrollment ID: I20150512001133 |
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