| Stancil Raney Medicine Pa | |
|
1475 Hogan Ln Suite #121 Conway AR 72034-8287 | |
| (501) 327-3344 | |
| (501) 327-2998 |
| Full Name | Stancil Raney Medicine Pa |
|---|---|
| Speciality | Family Medicine |
| Location | 1475 Hogan Ln, Conway, Arkansas |
| Authorized Official Name and Position | Vicki L Stancil (PRESIDENT) |
| Authorized Official Contact | 5013273344 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Stancil Raney Medicine Pa 1475 Hogan Ln Suite #121 Conway AR 72034-8287 Ph: (501) 327-3344 | Stancil Raney Medicine Pa 1475 Hogan Ln Suite #121 Conway AR 72034-8287 Ph: (501) 327-3344 |
| NPI Number | 1770555625 |
|---|---|
| Provider Enumeration Date | 02/05/2006 |
| Last Update Date | 06/22/2011 |
| Medicare PECOS PAC ID | 7214909019 |
|---|---|
| Medicare Enrollment ID | O20040811001124 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770555625 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QA0505X | Family Medicine - Adult Medicine | C6670 (Arkansas) | Primary |
| 207R00000X | Internal Medicine | C6656 (Arkansas) | Secondary |
| Provider Name | Vicki Stancil |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1891702205 PECOS PAC ID: 4688646433 Enrollment ID: I20040811000862 |
| Provider Name | Herschel Raney |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1639186273 PECOS PAC ID: 8820060684 Enrollment ID: I20040811000904 |
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