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1701 E North St Magnolia AR 71753-3204 | |
(870) 234-3802 | |
(870) 234-7386 |
Full Name | |
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Speciality | Family Medicine |
Location | 1701 E North St, Magnolia, Arkansas |
Authorized Official Name and Position | Ashley Campbell (OFFICE MANAGER) |
Authorized Official Contact | 8702343802 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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1701 E North St Magnolia AR 71753-3204 Ph: (870) 234-3802 | 1701 E North St Magnolia AR 71753-3204 Ph: (870) 234-3802 |
NPI Number | 1316101058 |
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Provider Enumeration Date | 07/11/2008 |
Last Update Date | 05/21/2024 |
Medicare PECOS PAC ID | 9436217973 |
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Medicare Enrollment ID | O20081028000032 |
Identifier | Type | State | Issuer |
---|---|---|---|
1316101058 | NPI | - | NPPES |
167832001 | Medicaid | AR |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | AR-E-5314 (Arkansas) | Primary |
Provider Name | Ked L Davis |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1699981894 PECOS PAC ID: 6709961410 Enrollment ID: I20080305000359 |
Fred Y Murphy Md Pa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1010 N Dudney Rd, Ste C, Magnolia, AR 71753 Phone: 870-234-7101 Fax: 870-234-7717 | |
Southern Medical Group Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 211 E Stadium, Magnolia, AR 71753 Phone: 870-234-5995 Fax: 870-234-0278 | |