| Lewisville Family Practice Center | |
|
1117 Chestnut Street Lewisville AR 71845 | |
| (870) 921-5781 | |
| (870) 921-4510 |
| Full Name | Lewisville Family Practice Center |
|---|---|
| Speciality | Family Medicine |
| Location | 1117 Chestnut Street, Lewisville, Arkansas |
| Authorized Official Name and Position | Susan Diane Johnston (BILLING SUPERVISOR) |
| Authorized Official Contact | 8707983515 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lewisville Family Practice Center Po Box 1013 Lewisville AR 71845-1013 Ph: (870) 921-5781 | Lewisville Family Practice Center 1117 Chestnut Street Lewisville AR 71845 Ph: (870) 921-5781 |
| NPI Number | 1437193646 |
|---|---|
| Provider Enumeration Date | 06/16/2006 |
| Last Update Date | 01/26/2012 |
| Medicare PECOS PAC ID | 9133029234 |
|---|---|
| Medicare Enrollment ID | O20060818000544 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437193646 | NPI | - | NPPES |
| 122632749 | Medicaid | AR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Lafayette County Family Practice Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 226 Spruce Street, Lewisville, AR 71845 Phone: 870-299-0480 |