| Mission Family Practice | |
|
2630 E Citizens Dr Suite #13 Fayetteville AR 72703-4797 | |
| (479) 571-6000 | |
| (479) 571-3344 |
| Full Name | Mission Family Practice |
|---|---|
| Speciality | Family Medicine |
| Location | 2630 E Citizens Dr, Fayetteville, Arkansas |
| Authorized Official Name and Position | Mark Andrew Bonner (PROVIDER) |
| Authorized Official Contact | 4795716000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mission Family Practice Po Box 3678 Fayetteville AR 72702-3678 Ph: (479) 571-6000 | Mission Family Practice 2630 E Citizens Dr Suite #13 Fayetteville AR 72703-4797 Ph: (479) 571-6000 |
| NPI Number | 1982009395 |
|---|---|
| Provider Enumeration Date | 10/28/2014 |
| Last Update Date | 10/24/2016 |
| Medicare PECOS PAC ID | 4587987540 |
|---|---|
| Medicare Enrollment ID | O20141223001222 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982009395 | NPI | - | NPPES |
| 113998001 | Medicaid | AR | |
| 51916 | Other | AR | UNSPECIFIED |
| P00200111 | Other | AR | RR MCR |
| 51916 | Other | AR | AR BC/BS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | C-7247 (Arkansas) | Primary |
| Provider Name | Mark A Bonner |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437188869 PECOS PAC ID: 6103885793 Enrollment ID: I20051122000300 |
| Provider Name | Kelly J Hardin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225206436 PECOS PAC ID: 9032289731 Enrollment ID: I20080606000749 |
| Provider Name | Ryan A Hueter |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1194967414 PECOS PAC ID: 1557510427 Enrollment ID: I20121009000670 |
| Provider Name | Debra G Walker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316998156 PECOS PAC ID: 2567597149 Enrollment ID: I20161219002562 |
| Provider Name | James Braxton Yeager |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922630367 PECOS PAC ID: 5496183139 Enrollment ID: I20200312000399 |
| Provider Name | Ginger Spiller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053998518 PECOS PAC ID: 4284043860 Enrollment ID: I20210512000031 |
| Provider Name | Shelly Lowry |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669086898 PECOS PAC ID: 3678964970 Enrollment ID: I20211221001859 |
| Provider Name | Diane H Morrow |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013636695 PECOS PAC ID: 7214313915 Enrollment ID: I20221004001438 |
| Provider Name | Trent A Hicks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598420911 PECOS PAC ID: 8628466125 Enrollment ID: I20221205003376 |
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 |