| Jimmerson Family Health Care P.a. | |
|
6917 Geyer Springs Rd Suite 4s Little Rock AR 72209-2727 | |
| (501) 569-9961 | |
| (501) 569-9903 |
| Full Name | Jimmerson Family Health Care P.a. |
|---|---|
| Speciality | Family Medicine |
| Location | 6917 Geyer Springs Rd, Little Rock, Arkansas |
| Authorized Official Name and Position | Robert Tyray Jimmerson (PHYSICIAN) |
| Authorized Official Contact | 5015699961 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jimmerson Family Health Care P.a. 6917 Geyer Springs Rd Suite 4s Little Rock AR 72209-2727 Ph: (501) 569-9961 | Jimmerson Family Health Care P.a. 6917 Geyer Springs Rd Suite 4s Little Rock AR 72209-2727 Ph: (501) 569-9961 |
| NPI Number | 1649496357 |
|---|---|
| Provider Enumeration Date | 04/18/2007 |
| Last Update Date | 05/06/2008 |
| Medicare PECOS PAC ID | 9638265580 |
|---|---|
| Medicare Enrollment ID | O20071023000694 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649496357 | NPI | - | NPPES |
| 18321000000 | Other | AR | QUAL CHOICE |
| 135241001 | Medicaid | AR | |
| 2451550 | Other | AETNA | |
| 2717169 | Other | CIGNA | |
| 5K890 | Other | AR | BCBS |
| 080158974 | Other | AR | PALMETTOGBA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | E-1845 (Arkansas) | Primary |
| Provider Name | Robert T Jimmerson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1619046679 PECOS PAC ID: 3577586023 Enrollment ID: I20060110001108 |
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