R Keith Davis Md Pllc Pa | |
1400 Pershing Hwy Smackover AR 71762-2300 | |
(870) 725-3471 | |
(870) 725-3215 |
Full Name | R Keith Davis Md Pllc Pa |
---|---|
Speciality | Family Medicine |
Location | 1400 Pershing Hwy, Smackover, Arkansas |
Authorized Official Name and Position | Richard K Davis (SOLE MEMBER) |
Authorized Official Contact | 8707253471 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
R Keith Davis Md Pllc Pa Po Box 69 Smackover AR 71762-0069 Ph: (870) 725-3471 | R Keith Davis Md Pllc Pa 1400 Pershing Hwy Smackover AR 71762-2300 Ph: (870) 725-3471 |
NPI Number | 1659604064 |
---|---|
Provider Enumeration Date | 09/16/2009 |
Last Update Date | 09/23/2009 |
Medicare PECOS PAC ID | 3173669199 |
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Medicare Enrollment ID | O20091006000184 |
Identifier | Type | State | Issuer |
---|---|---|---|
1659604064 | NPI | - | NPPES |
145479001 | Medicaid | AR |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | E3055 (Arkansas) | Primary |
Provider Name | Richard Keith Davis |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1104826320 PECOS PAC ID: 8224923966 Enrollment ID: I20040220000216 |
Provider Name | Karen Everett |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1972855161 PECOS PAC ID: 2567614811 Enrollment ID: I20121212000487 |
Provider Name | Tanya M Golden |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1275071755 PECOS PAC ID: 0345525127 Enrollment ID: I20170316002497 |
Richard K Davis Md Pllc Pa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1400 Pershing Hwy, Smackover, AR 71762 Phone: 870-725-3471 Fax: 870-725-3215 | |
R Keith Davis Md Pllc Pa School Based Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 727 Buckaroo Ln, Smackover, AR 71762 Phone: 870-725-3471 Fax: 870-725-3041 | |
Clint A Netherland, Md, Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1400 Pershing Hwy, Smackover, AR 71762 Phone: 870-725-3471 Fax: 870-725-3041 |