Buffalo Island Medical Clinic- Leachville | |
111 S Main St Leachville AR 72438-9097 | |
(870) 539-1115 | |
(870) 539-1125 |
Full Name | Buffalo Island Medical Clinic- Leachville |
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Speciality | Family Medicine |
Location | 111 S Main St, Leachville, Arkansas |
Authorized Official Name and Position | John Lieblong (VP PHYSICIAN SERVICES) |
Authorized Official Contact | 8709327024 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Buffalo Island Medical Clinic- Leachville 800 S. Main P.o. Box 1331 Jonesboro AR 72403-1331 Ph: (870) 932-7024 | Buffalo Island Medical Clinic- Leachville 111 S Main St Leachville AR 72438-9097 Ph: (870) 539-1115 |
NPI Number | 1871970202 |
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Provider Enumeration Date | 05/06/2015 |
Last Update Date | 11/21/2019 |
Medicare PECOS PAC ID | 7315844586 |
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Medicare Enrollment ID | O20150604000372 |
Identifier | Type | State | Issuer |
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1871970202 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | Jason S Paxton |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1992768212 PECOS PAC ID: 2567364813 Enrollment ID: I20040126000690 |
Provider Name | Heather L Smith |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1982671699 PECOS PAC ID: 5395784151 Enrollment ID: I20050430000066 |
Provider Name | Walter M Short |
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Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1649295833 PECOS PAC ID: 3476639832 Enrollment ID: I20080325000694 |
Provider Name | Brian A Baltz |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1205064581 PECOS PAC ID: 0446413314 Enrollment ID: I20120514000419 |
Provider Name | Sarah Crook |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1871908483 PECOS PAC ID: 7719103464 Enrollment ID: I20140801000796 |