| Spring River Clinic, Llc | |
|
201 N Walnut St Imboden AR 72434-9160 | |
| (423) 534-4917 | |
| Not Available |
| Full Name | Spring River Clinic, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 201 N Walnut St, Imboden, Arkansas |
| Authorized Official Name and Position | Jefferydon Lee Coon (MANAGER) |
| Authorized Official Contact | 4235344917 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Spring River Clinic, Llc 2803 Sparrow Hawk Ln Pocahontas AR 72455-1486 Ph: (423) 534-4917 | Spring River Clinic, Llc 201 N Walnut St Imboden AR 72434-9160 Ph: (423) 534-4917 |
| NPI Number | 1598356982 |
|---|---|
| Provider Enumeration Date | 01/29/2021 |
| Last Update Date | 01/29/2021 |
| Medicare PECOS PAC ID | 5193133676 |
|---|---|
| Medicare Enrollment ID | O20210422000064 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598356982 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Jefferydon Lee Coon |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1376834101 PECOS PAC ID: 4981995370 Enrollment ID: I20160615000084 |
| Provider Name | Vickey Snow |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114468923 PECOS PAC ID: 8628345477 Enrollment ID: I20170525002109 |
| Provider Name | Hannah Cagle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295360360 PECOS PAC ID: 3779912829 Enrollment ID: I20200411000056 |
| Provider Name | Kayla Godsey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497320337 PECOS PAC ID: 8224425533 Enrollment ID: I20220504002378 |
Imboden Rural Health Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 201 N Walnut Street, Imboden, AR 72434 Phone: 870-869-3101 Fax: 870-869-3014 | |
Imboden Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 201 N Walnut Street, Imboden, AR 72434 Phone: 870-869-3101 Fax: 870-869-3014 | |
Genesis Health And Wellness, Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 110 N Hendrix St, Imboden, AR 72434 Phone: 870-378-4602 |