| Stonehaven Medical Group, Pllc | |
|
4519 N Garfield St Ste 1 Midland TX 79705-3400 | |
| (432) 219-9200 | |
| (432) 218-7879 |
| Full Name | Stonehaven Medical Group, Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 4519 N Garfield St Ste 1, Midland, Texas |
| Authorized Official Name and Position | Rickey W Hamby (MD/OWNER) |
| Authorized Official Contact | 4322199200 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Stonehaven Medical Group, Pllc 4416 Briarwood Ave # 110-87 Midland TX 79707-2615 Ph: (432) 219-9200 | Stonehaven Medical Group, Pllc 4519 N Garfield St Ste 1 Midland TX 79705-3400 Ph: (432) 219-9200 |
| NPI Number | 1982202263 |
|---|---|
| Provider Enumeration Date | 10/09/2020 |
| Last Update Date | 05/05/2022 |
| Medicare PECOS PAC ID | 6507255296 |
|---|---|
| Medicare Enrollment ID | O20211118002498 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982202263 | NPI | - | NPPES |
| P7455 | Other | TX | TX MEDICAL LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Rickey W Hamby |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1891084372 PECOS PAC ID: 0244454213 Enrollment ID: I20140612001722 |
| Provider Name | George Alva |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639766140 PECOS PAC ID: 6406245661 Enrollment ID: I20211110001445 |
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