Full Name | |
---|---|
Speciality | Family Medicine |
Location | 253 S Concord, Strong, Arkansas |
Authorized Official Name and Position | Susan Diane Johnston (BILLING SUPERVISOR) |
Authorized Official Contact | 8707984064 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Po Box 565 Strong AR 71765-0565 Ph: (870) 797-7620 | 253 S Concord Strong AR 71765 Ph: (870) 797-7620 |
NPI Number | 1821032046 |
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Provider Enumeration Date | 06/16/2006 |
Last Update Date | 01/31/2012 |
Medicare PECOS PAC ID | 9133029234 |
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Medicare Enrollment ID | O20060818000545 |
Identifier | Type | State | Issuer |
---|---|---|---|
1821032046 | NPI | - | NPPES |
122633749 | Medicaid | AR |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |