Jerry L Harvey, Do, Pa | |
15361 Highway 5 Suite E Cabot AR 72023-5128 | |
(501) 605-9355 | |
Not Available |
Full Name | Jerry L Harvey, Do, Pa |
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Speciality | Clinic/Center |
Location | 15361 Highway 5, Cabot, Arkansas |
Authorized Official Name and Position | Jerry Harvey (PRESIDENT) |
Authorized Official Contact | 5016059355 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Jerry L Harvey, Do, Pa 15361 Highway 5 Suite E Cabot AR 72023-5128 Ph: (501) 605-9355 | Jerry L Harvey, Do, Pa 15361 Highway 5 Suite E Cabot AR 72023-5128 Ph: (501) 605-9355 |
NPI Number | 1477781680 |
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Provider Enumeration Date | 06/25/2009 |
Last Update Date | 06/25/2009 |
Medicare PECOS PAC ID | 6800941816 |
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Medicare Enrollment ID | O20090827000027 |
Identifier | Type | State | Issuer |
---|---|---|---|
1477781680 | NPI | - | NPPES |
125608003 | Medicaid | AR | |
5J444 | Other | AR | MEDICARE ID-TYPE UNSPECIFIED |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
Provider Name | Jerry L Harvey |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1487602470 PECOS PAC ID: 6608877832 Enrollment ID: I20070130000650 |
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