St Mary's Physician Services Llc | |
101 Skyline Dr Russellville AR 72801-3363 | |
(479) 968-2345 | |
(479) 890-2497 |
Full Name | St Mary's Physician Services Llc |
---|---|
Speciality | General Practice |
Location | 101 Skyline Dr, Russellville, Arkansas |
Authorized Official Name and Position | Charlotte Lawrence (SECRETARY) |
Authorized Official Contact | 6159207000 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
St Mary's Physician Services Llc 101 Skyline Dr Russellville AR 72801-3363 Ph: (479) 968-2345 | St Mary's Physician Services Llc 101 Skyline Dr Russellville AR 72801-3363 Ph: (479) 968-2345 |
NPI Number | 1124084991 |
---|---|
Provider Enumeration Date | 04/21/2006 |
Last Update Date | 09/26/2024 |
Medicare PECOS PAC ID | 4981698032 |
---|---|
Medicare Enrollment ID | O20040609000759 |
Identifier | Type | State | Issuer |
---|---|---|---|
1124084991 | NPI | - | NPPES |
DA8026 | Other | RAILROAD MEDICARE PTAN | |
152955002 | Medicaid | AR |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
208D00000X | General Practice | (* (Not Available)) | Primary |
Provider Name | Zbigniew T Beyga |
---|---|
Provider Type | Practitioner - General Surgery |
Provider Identifiers | NPI Number: 1699743831 PECOS PAC ID: 1658277819 Enrollment ID: I20031209000499 |
Provider Name | Timothy Samuel Johnson |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1023074119 PECOS PAC ID: 3375536303 Enrollment ID: I20040406000815 |
Provider Name | Lynette J Smith |
---|---|
Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1134185317 PECOS PAC ID: 8022001064 Enrollment ID: I20040406000893 |
Provider Name | Jeffrey K Yates |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1932165024 PECOS PAC ID: 3577556448 Enrollment ID: I20040406001231 |
Provider Name | Homer Kevin Beavers |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1982660742 PECOS PAC ID: 0042203945 Enrollment ID: I20040406001381 |
Provider Name | James M Carter |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1518923861 PECOS PAC ID: 8123012242 Enrollment ID: I20040412001564 |
Provider Name | Michael F Bell |
---|---|
Provider Type | Practitioner - General Surgery |
Provider Identifiers | NPI Number: 1407812589 PECOS PAC ID: 3375537111 Enrollment ID: I20040413001576 |
Provider Name | Dennis W Berner |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1760448534 PECOS PAC ID: 7012902240 Enrollment ID: I20040417000221 |
Provider Name | James Crouch |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1437115508 PECOS PAC ID: 4587659727 Enrollment ID: I20040417000284 |
Provider Name | Jody C Callaway |
---|---|
Provider Type | Practitioner - Obstetrics/gynecology |
Provider Identifiers | NPI Number: 1245296961 PECOS PAC ID: 4880689942 Enrollment ID: I20040417000479 |
Provider Name | William S Sosebee |
---|---|
Provider Type | Practitioner - Obstetrics/gynecology |
Provider Identifiers | NPI Number: 1326004060 PECOS PAC ID: 3375538143 Enrollment ID: I20040420000324 |
Provider Name | Barry William Mccraw |
---|---|
Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1831155191 PECOS PAC ID: 7315938487 Enrollment ID: I20040519000590 |
Provider Name | G Scott S Dicus |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1033100433 PECOS PAC ID: 0446234603 Enrollment ID: I20040615001315 |
Provider Name | Michael Brandon Pafford |
---|---|
Provider Type | Practitioner - Hospitalist |
Provider Identifiers | NPI Number: 1508814617 PECOS PAC ID: 4587649314 Enrollment ID: I20040623001692 |
Provider Name | Keith A Ison |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1497711279 PECOS PAC ID: 5193701431 Enrollment ID: I20040628000039 |
Provider Name | Arlis D Barton |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1528024866 PECOS PAC ID: 4880668813 Enrollment ID: I20040824001295 |
Provider Name | Fauzia Qadir |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1982616231 PECOS PAC ID: 6507826781 Enrollment ID: I20041012001339 |
Provider Name | Michael W Escue |
---|---|
Provider Type | Practitioner - Obstetrics/gynecology |
Provider Identifiers | NPI Number: 1871559955 PECOS PAC ID: 8820029796 Enrollment ID: I20050830000993 |
Provider Name | Stephen P King |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1144266727 PECOS PAC ID: 2062405020 Enrollment ID: I20060824000061 |
Provider Name | Mary Melissa Darnell |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1497964571 PECOS PAC ID: 6709975147 Enrollment ID: I20071207000515 |
Provider Name | Carey Ellis Laffoon |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1720284318 PECOS PAC ID: 8921198896 Enrollment ID: I20071214000648 |
Provider Name | Muhammad I Shakir |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1952352213 PECOS PAC ID: 0446336408 Enrollment ID: I20080401000167 |
Provider Name | Rick Harrison |
---|---|
Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1316903669 PECOS PAC ID: 6103819115 Enrollment ID: I20080611000182 |
Provider Name | Owen L Kelly |
---|---|
Provider Type | Practitioner - Orthopedic Surgery |
Provider Identifiers | NPI Number: 1962461707 PECOS PAC ID: 5092801472 Enrollment ID: I20080618000168 |
Provider Name | Venkata Subrahmanya Sastry Prayaga |
---|---|
Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
Provider Identifiers | NPI Number: 1487699864 PECOS PAC ID: 3274509260 Enrollment ID: I20080822000534 |
Provider Name | Dave D Weems |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1710974944 PECOS PAC ID: 9638136914 Enrollment ID: I20081008000716 |
Provider Name | Michael B. Mayfield |
---|---|
Provider Type | Practitioner - General Surgery |
Provider Identifiers | NPI Number: 1306894803 PECOS PAC ID: 3577623073 Enrollment ID: I20081113000336 |
Provider Name | Sheharyar Ali |
---|---|
Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
Provider Identifiers | NPI Number: 1427099712 PECOS PAC ID: 6901792423 Enrollment ID: I20090616000247 |
Provider Name | Kim Graves |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1245200971 PECOS PAC ID: 8123192846 Enrollment ID: I20091207000074 |
Provider Name | David G Nelson |
---|---|
Provider Type | Practitioner - Obstetrics/gynecology |
Provider Identifiers | NPI Number: 1720109796 PECOS PAC ID: 9537291828 Enrollment ID: I20100722000380 |
Provider Name | Christina M Bartlett |
---|---|
Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1649484452 PECOS PAC ID: 0941333637 Enrollment ID: I20100802000599 |
Provider Name | Thomas Reinsvold |
---|---|
Provider Type | Practitioner - Interventional Cardiology |
Provider Identifiers | NPI Number: 1154367332 PECOS PAC ID: 8820060650 Enrollment ID: I20100823000846 |
Provider Name | Kristen M Nelson |
---|---|
Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1073720868 PECOS PAC ID: 2365637212 Enrollment ID: I20101117000705 |
Provider Name | Sudheer Koyagura |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1528261617 PECOS PAC ID: 8820283799 Enrollment ID: I20101117000970 |
Provider Name | Ahmad Kaako |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1679798995 PECOS PAC ID: 7416142302 Enrollment ID: I20101117001185 |
Provider Name | Darren S Freeman |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1740442284 PECOS PAC ID: 6305021130 Enrollment ID: I20110421000089 |
Provider Name | Shagufta Siddiqui |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1710996863 PECOS PAC ID: 6305010968 Enrollment ID: I20111116000273 |
Provider Name | William W Thorpe |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1013148832 PECOS PAC ID: 7012183155 Enrollment ID: I20111220000640 |
Provider Name | Stanley D Teeter |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1932401080 PECOS PAC ID: 9638338726 Enrollment ID: I20120308000737 |
Provider Name | Kelly A Traylor |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1629343868 PECOS PAC ID: 6002078599 Enrollment ID: I20120430000080 |
Provider Name | Shuja Rasool |
---|---|
Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
Provider Identifiers | NPI Number: 1588841340 PECOS PAC ID: 9638232788 Enrollment ID: I20120809000736 |
Provider Name | Wassim T Radwan Abd El Wahab |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1629208434 PECOS PAC ID: 1951559335 Enrollment ID: I20120910000065 |
Provider Name | Bashar Obeidou |
---|---|
Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
Provider Identifiers | NPI Number: 1033297031 PECOS PAC ID: 4385558196 Enrollment ID: I20121002000479 |
Provider Name | Abdul Hakeem |
---|---|
Provider Type | Practitioner - Interventional Cardiology |
Provider Identifiers | NPI Number: 1285684845 PECOS PAC ID: 0941459606 Enrollment ID: I20121012000627 |
Provider Name | Christina M Clark |
---|---|
Provider Type | Practitioner - Obstetrics/gynecology |
Provider Identifiers | NPI Number: 1588807135 PECOS PAC ID: 7012153596 Enrollment ID: I20130430000028 |
Provider Name | Michael Mcalister |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1629398276 PECOS PAC ID: 8820237076 Enrollment ID: I20130619000064 |
Provider Name | Herbert A Lewis |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1558657635 PECOS PAC ID: 1254572597 Enrollment ID: I20130729000538 |
Provider Name | Syed A Athar |
---|---|
Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
Provider Identifiers | NPI Number: 1508038597 PECOS PAC ID: 6305916313 Enrollment ID: I20130917000257 |
Provider Name | Christian Orji |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1700172145 PECOS PAC ID: 0143459909 Enrollment ID: I20140128000503 |
Provider Name | Chadwick J. Masters |
---|---|
Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1326339557 PECOS PAC ID: 8527281864 Enrollment ID: I20140514000958 |
Provider Name | Howard M Orsburn |
---|---|
Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1376834994 PECOS PAC ID: 3779706932 Enrollment ID: I20140516000426 |
Provider Name | Noma W Kellner |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1194144964 PECOS PAC ID: 0446474373 Enrollment ID: I20140617000685 |
Provider Name | Carl Schoenberger |
---|---|
Provider Type | Practitioner - Pulmonary Disease |
Provider Identifiers | NPI Number: 1619971140 PECOS PAC ID: 6103952429 Enrollment ID: I20141104002794 |
Provider Name | Kelly Wright |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1720479223 PECOS PAC ID: 8820315161 Enrollment ID: I20150325000506 |
Provider Name | Rex L Porte |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1801235783 PECOS PAC ID: 4284940917 Enrollment ID: I20150826001118 |
Provider Name | Gina Marie Vargas |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1720218894 PECOS PAC ID: 1850557414 Enrollment ID: I20150914000781 |
Provider Name | Kate Gazenko |
---|---|
Provider Type | Practitioner - General Surgery |
Provider Identifiers | NPI Number: 1245435213 PECOS PAC ID: 2769625045 Enrollment ID: I20150918001153 |
Provider Name | Nathan R Henderson |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1013250182 PECOS PAC ID: 9133430085 Enrollment ID: I20150928000657 |
Provider Name | Lensey C Scott |
---|---|
Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
Provider Identifiers | NPI Number: 1225126626 PECOS PAC ID: 7416082797 Enrollment ID: I20151223000334 |
Provider Name | Malek Al-hawwas |
---|---|
Provider Type | Practitioner - Interventional Cardiology |
Provider Identifiers | NPI Number: 1093980526 PECOS PAC ID: 6204988256 Enrollment ID: I20160121002335 |
Provider Name | Jonathan D Brixey |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1629336078 PECOS PAC ID: 5092032912 Enrollment ID: I20160607000477 |
Provider Name | Ahmad Yousaf |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1033405824 PECOS PAC ID: 8527375773 Enrollment ID: I20160827000028 |
Provider Name | Erin Jo Dodge |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1245683895 PECOS PAC ID: 4789970740 Enrollment ID: I20160831001341 |
Provider Name | Praveen Natakal Pakeerappa |
---|---|
Provider Type | Practitioner - Physical Medicine And Rehabilitation |
Provider Identifiers | NPI Number: 1457645830 PECOS PAC ID: 8729387964 Enrollment ID: I20160831002351 |
Provider Name | Yazan Ghosheh |
---|---|
Provider Type | Practitioner - Interventional Cardiology |
Provider Identifiers | NPI Number: 1861706046 PECOS PAC ID: 6406159649 Enrollment ID: I20170724003363 |
Provider Name | Janet K Corbett |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1104838945 PECOS PAC ID: 0547166001 Enrollment ID: I20170926002281 |
Provider Name | Sara Damron |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1104340645 PECOS PAC ID: 1557636701 Enrollment ID: I20171013002102 |
Provider Name | James Albert Johnson |
---|---|
Provider Type | Practitioner - General Surgery |
Provider Identifiers | NPI Number: 1053378257 PECOS PAC ID: 8325001662 Enrollment ID: I20180124000791 |
Provider Name | Vishwanatha Nadig |
---|---|
Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
Provider Identifiers | NPI Number: 1740266998 PECOS PAC ID: 1355330242 Enrollment ID: I20180223000081 |
Provider Name | Anita Xayapheth |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1962919282 PECOS PAC ID: 0749541001 Enrollment ID: I20180301000100 |
Provider Name | Jennifer Jacobs |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1134622806 PECOS PAC ID: 2365705431 Enrollment ID: I20180424002692 |
Provider Name | Hannah Jones |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1316443898 PECOS PAC ID: 9032473129 Enrollment ID: I20180425001110 |
Provider Name | Jeremiah Scott Rutherford |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1801035969 PECOS PAC ID: 3870633183 Enrollment ID: I20180426000259 |
Provider Name | Stormy Elaine Stane |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1851894075 PECOS PAC ID: 2860756848 Enrollment ID: I20180426002481 |
Provider Name | Ashley N Baker |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1891294443 PECOS PAC ID: 4284998022 Enrollment ID: I20180503000935 |
Provider Name | Zachary Morrill |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1063894194 PECOS PAC ID: 7810205309 Enrollment ID: I20180629001718 |
Provider Name | Kapil Yadav |
---|---|
Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
Provider Identifiers | NPI Number: 1265729537 PECOS PAC ID: 8123374923 Enrollment ID: I20180710000876 |
Provider Name | Jefferson John Cartwright |
---|---|
Provider Type | Practitioner - Orthopedic Surgery |
Provider Identifiers | NPI Number: 1285678300 PECOS PAC ID: 7012810179 Enrollment ID: I20180827000656 |
Provider Name | Kendra Leann Fletcher |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1912486648 PECOS PAC ID: 7517210586 Enrollment ID: I20181022003081 |
Provider Name | Muhammad Khalil |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1184038598 PECOS PAC ID: 4880950401 Enrollment ID: I20181211000968 |
Provider Name | Robert Leighton Hubley |
---|---|
Provider Type | Practitioner - Hospitalist |
Provider Identifiers | NPI Number: 1659537736 PECOS PAC ID: 3375690522 Enrollment ID: I20190131001759 |
Provider Name | Rande Brooke Rye |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1225594336 PECOS PAC ID: 6608109715 Enrollment ID: I20190605000124 |
Provider Name | Syed Mustafa |
---|---|
Provider Type | Practitioner - Pulmonary Disease |
Provider Identifiers | NPI Number: 1326393885 PECOS PAC ID: 9739413022 Enrollment ID: I20190619003530 |
Provider Name | Keena Noelle Melton |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1467835611 PECOS PAC ID: 3971830506 Enrollment ID: I20190806000585 |
Provider Name | Michael Douglas Davis |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1063866135 PECOS PAC ID: 4981932282 Enrollment ID: I20190824000178 |
Provider Name | Orin Paul Trentham |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1992740260 PECOS PAC ID: 1850489568 Enrollment ID: I20200319002706 |
Provider Name | Cindy Nicole Burnett |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1699308544 PECOS PAC ID: 4385073014 Enrollment ID: I20200401001710 |
Provider Name | Keely Hatfield |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1104459478 PECOS PAC ID: 0042649790 Enrollment ID: I20200401002574 |
Provider Name | Blake Dixon |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1518316702 PECOS PAC ID: 7315295854 Enrollment ID: I20200619001164 |
Provider Name | Norman Weinstein |
---|---|
Provider Type | Practitioner - Interventional Cardiology |
Provider Identifiers | NPI Number: 1992754360 PECOS PAC ID: 3577559319 Enrollment ID: I20200903000838 |
Provider Name | Colin Adrian Meghoo |
---|---|
Provider Type | Practitioner - General Surgery |
Provider Identifiers | NPI Number: 1871660597 PECOS PAC ID: 7416249610 Enrollment ID: I20201020001839 |
Provider Name | Judith Degraff |
---|---|
Provider Type | Practitioner - General Surgery |
Provider Identifiers | NPI Number: 1467544403 PECOS PAC ID: 8527952233 Enrollment ID: I20210121001492 |
Provider Name | Joseph M Sturdivant |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1053514455 PECOS PAC ID: 7517123342 Enrollment ID: I20210419000037 |
Provider Name | Kathryn I Parker |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1285087429 PECOS PAC ID: 2466728530 Enrollment ID: I20210615001425 |
Provider Name | Julia Michelle Hall |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1477045680 PECOS PAC ID: 8224432281 Enrollment ID: I20210812002617 |
Provider Name | Anusha Jillella |
---|---|
Provider Type | Practitioner - Medical Oncology |
Provider Identifiers | NPI Number: 1760845804 PECOS PAC ID: 6305138504 Enrollment ID: I20210818003600 |
Provider Name | Rachana Dandamudi Miller |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1295231504 PECOS PAC ID: 5193120319 Enrollment ID: I20210825002754 |
Provider Name | Swapna Manyam |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1326500406 PECOS PAC ID: 6103151634 Enrollment ID: I20220131000319 |
Provider Name | Zoltan Varga |
---|---|
Provider Type | Practitioner - Interventional Cardiology |
Provider Identifiers | NPI Number: 1336645225 PECOS PAC ID: 8123382306 Enrollment ID: I20220610000144 |
Provider Name | Nathaniel Eastman |
---|---|
Provider Type | Practitioner - General Surgery |
Provider Identifiers | NPI Number: 1023125887 PECOS PAC ID: 9830163120 Enrollment ID: I20220706001692 |
Provider Name | Daniel Para |
---|---|
Provider Type | Practitioner - General Surgery |
Provider Identifiers | NPI Number: 1205830684 PECOS PAC ID: 0042103152 Enrollment ID: I20220713002921 |
Provider Name | Mina Michael |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1124687157 PECOS PAC ID: 1850779224 Enrollment ID: I20220718002524 |
Provider Name | John D Ferguson |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1104387562 PECOS PAC ID: 2264766229 Enrollment ID: I20220725001130 |
Provider Name | Mateo Guarderas Ribadeneira |
---|---|
Provider Type | Practitioner - General Surgery |
Provider Identifiers | NPI Number: 1487004990 PECOS PAC ID: 6406238229 Enrollment ID: I20220726003327 |
Provider Name | Muska Ullah |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1265094213 PECOS PAC ID: 5799012803 Enrollment ID: I20220830004030 |
Provider Name | Juiting Chen |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1235844952 PECOS PAC ID: 6709258353 Enrollment ID: I20230208002754 |
Provider Name | Chaitanya Korrapati |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1033524863 PECOS PAC ID: 5092096610 Enrollment ID: I20230215000925 |
Provider Name | Victoria Jayne Langford |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1386340222 PECOS PAC ID: 2567835937 Enrollment ID: I20230306001321 |
Provider Name | Matthew C Steele |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1801425202 PECOS PAC ID: 4183046287 Enrollment ID: I20230814003243 |
Provider Name | Heather Marie Jones |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1447932033 PECOS PAC ID: 7416301395 Enrollment ID: I20230926003069 |
Russellville Family Clinic Pa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 108 Skyline Dr, Russellville, AR 72801 Phone: 479-968-7170 Fax: 479-968-7607 | |
Arcare Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2424 W Main St, Russellville, AR 72801 Phone: 501-500-5001 Fax: 501-500-5001 | |
Monfee Medical Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 3812 W. Main St., Russellville, AR 72811 Phone: 479-968-1245 Fax: 479-968-4137 | |
Wellness Consulting Services Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1605 West C Place, Russellville, AR 72801 Phone: 479-890-9355 | |
Conway Regional Medical Clinic-russellville Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 108 Skyline Dr, Russellville, AR 72801 Phone: 479-968-7170 Fax: 479-968-7607 | |
River Valley Aba Services Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3205 W Main St, Russellville, AR 72801 Phone: 479-968-1198 |