Premiere Family Practice | |
1904 Grant Ave Ste G Jonesboro AR 72401-6165 | |
(870) 243-4136 | |
Not Available |
Full Name | Premiere Family Practice |
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Speciality | Family Medicine |
Location | 1904 Grant Ave Ste G, Jonesboro, Arkansas |
Authorized Official Name and Position | Carolyn Coleman (OWNER) |
Authorized Official Contact | 8704933007 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Premiere Family Practice 1904 Grant Ave Ste G Jonesboro AR 72401-6165 Ph: (870) 493-3007 | Premiere Family Practice 1904 Grant Ave Ste G Jonesboro AR 72401-6165 Ph: (870) 243-4136 |
NPI Number | 1932708641 |
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Provider Enumeration Date | 10/22/2020 |
Last Update Date | 02/11/2022 |
Medicare PECOS PAC ID | 0244632073 |
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Medicare Enrollment ID | O20210715001998 |
Identifier | Type | State | Issuer |
---|---|---|---|
1932708641 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | Carolyn A Coleman |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1407388267 PECOS PAC ID: 4183980824 Enrollment ID: I20190328001890 |
Provider Name | Elham A Armah |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1851718381 PECOS PAC ID: 0244453124 Enrollment ID: I20210719000051 |
Provider Name | Gregory Szych |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1841268521 PECOS PAC ID: 4688655467 Enrollment ID: I20210907001242 |
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