| Jennifer Bingham Md Pllc | |
|
15785 W Highway 62 Ste 1 Prairie Grove AR 72753-9201 | |
| (479) 351-9476 | |
| (479) 287-4586 |
| Full Name | Jennifer Bingham Md Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 15785 W Highway 62 Ste 1, Prairie Grove, Arkansas |
| Authorized Official Name and Position | Jennifer Bingham (OWNER/PHYSICIAN) |
| Authorized Official Contact | 4793519476 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jennifer Bingham Md Pllc 15785 W Highway 62 Prairie Grove AR 72753-9201 Ph: (479) 351-9476 | Jennifer Bingham Md Pllc 15785 W Highway 62 Ste 1 Prairie Grove AR 72753-9201 Ph: (479) 351-9476 |
| NPI Number | 1083978977 |
|---|---|
| Provider Enumeration Date | 06/26/2012 |
| Last Update Date | 11/13/2020 |
| Medicare PECOS PAC ID | 8628233855 |
|---|---|
| Medicare Enrollment ID | O20120712000854 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083978977 | NPI | - | NPPES |
| 135065001 | Medicaid | AR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Jennifer Ann Bingham |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1609819077 PECOS PAC ID: 5193751600 Enrollment ID: I20100706000305 |
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