| Main Street Medical | |
|
2603 Main Dr Suite 6 Fayetteville AR 72704-5278 | |
| (479) 571-4325 | |
| (479) 571-4329 |
| Full Name | Main Street Medical |
|---|---|
| Speciality | General Practice |
| Location | 2603 Main Dr, Fayetteville, Arkansas |
| Authorized Official Name and Position | Scott Fedosky (PHYSICIAN) |
| Authorized Official Contact | 4795714325 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Main Street Medical 2603 Main Dr Suite 6 Fayetteville AR 72704-5278 Ph: (479) 571-4325 | Main Street Medical 2603 Main Dr Suite 6 Fayetteville AR 72704-5278 Ph: (479) 571-4325 |
| NPI Number | 1356582035 |
|---|---|
| Provider Enumeration Date | 03/10/2009 |
| Last Update Date | 04/08/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356582035 | NPI | - | NPPES |
| 1710993654 | Other | NPPES - INDIVIDUAL NPI NUMBER | |
| 179094002 | Other | AR | DESIGNING HEALTH, PA MEDICAID ORGANIZATIONAL NUMBER |
| 167302001 | Other | AR | MEDICAID PERSONAL NUMBER |
| 5G182 | Other | AR | MEDICARE PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | E2717 (Arkansas) | Secondary |
| 208D00000X | General Practice | E0546 (Arkansas) | Primary |
Community Clinic Fayetteville Medical Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 3162 W Martin Luther King Blvd, Suites 13 & 14, Fayetteville, AR 72704 Phone: 479-935-4834 Fax: 479-751-2878 | |
K E Management Services Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1420 E Augustine Ln Ste 7, Fayetteville, AR 72703 Phone: 479-200-9812 Fax: 866-243-7203 | |
Bryan Abernathy Md Pa Dba Abernathy Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1806 N Crossover Rd, Suite 4, Fayetteville, AR 72701 Phone: 479-521-5603 Fax: 479-521-5773 | |
Truhealth Family Care Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2630 E Citizens Dr, Suite 3, Fayetteville, AR 72703 Phone: 479-527-9966 Fax: 479-527-9677 | |
Washington County Hiv Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 3270 N. Wimberly Drive, Fayetteville, AR 72703 Phone: 479-973-8450 Fax: 479-973-8452 | |
Arcare Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1792 E Joyce Blvd, Fayetteville, AR 72703 Phone: 501-500-5001 Fax: 501-500-5001 | |
Dr James Dunn Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 4368 E Churchill Dr, Fayetteville, AR 72701 Phone: 479-442-4553 Fax: 479-251-1006 |