Main Street Medical Clinic | |
707 N Main St Harrison AR 72601-2912 | |
(870) 741-3592 | |
(870) 741-7733 |
Full Name | Main Street Medical Clinic |
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Speciality | Family Medicine |
Location | 707 N Main St, Harrison, Arkansas |
Authorized Official Name and Position | Charles R. Klepper (OWNER) |
Authorized Official Contact | 8707413592 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Main Street Medical Clinic 707 N Main St Harrison AR 72601-2912 Ph: (870) 741-3592 | Main Street Medical Clinic 707 N Main St Harrison AR 72601-2912 Ph: (870) 741-3592 |
NPI Number | 1245345958 |
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Provider Enumeration Date | 08/20/2006 |
Last Update Date | 04/30/2014 |
Medicare PECOS PAC ID | 3476511288 |
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Medicare Enrollment ID | O20041227000708 |
Identifier | Type | State | Issuer |
---|---|---|---|
1245345958 | NPI | - | NPPES |
5B704 | Other | AR | ARK. BLUE SHIELD |
127780002 | Medicaid | AR |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207QG0300X | Family Medicine - Geriatric Medicine | (* (Not Available)) | Primary |
Provider Name | Elizabeth O Cheek |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1417051129 PECOS PAC ID: 6103826367 Enrollment ID: I20070111000446 |
Provider Name | Charles R. Klepper |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1942275334 PECOS PAC ID: 6103884911 Enrollment ID: I20100612000129 |
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