| Melloy Concierge And Aesthetics Medical Group | |
|
200 S 20th St Ste C Rogers AR 72758-1100 | |
| (479) 278-7010 | |
| (479) 974-2009 |
| Full Name | Melloy Concierge And Aesthetics Medical Group |
|---|---|
| Speciality | Family Medicine |
| Location | 200 S 20th St Ste C, Rogers, Arkansas |
| Authorized Official Name and Position | Brian D Melloy (OWNER/DOCTOR) |
| Authorized Official Contact | 5052394902 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Melloy Concierge And Aesthetics Medical Group 200 S 20th St Ste C Rogers AR 72758-1100 Ph: (479) 278-7010 | Melloy Concierge And Aesthetics Medical Group 200 S 20th St Ste C Rogers AR 72758-1100 Ph: (479) 278-7010 |
| NPI Number | 1184311342 |
|---|---|
| Provider Enumeration Date | 04/19/2023 |
| Last Update Date | 06/29/2023 |
| Medicare PECOS PAC ID | 5698135903 |
|---|---|
| Medicare Enrollment ID | O20230718003972 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184311342 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Renee Kassir |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1336375674 PECOS PAC ID: 0547424095 Enrollment ID: I20120612000638 |
| Provider Name | Brian D Melloy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1457716813 PECOS PAC ID: 2769786607 Enrollment ID: I20180322002116 |
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