Full Name | |
---|---|
Speciality | Clinic/center - Multi-specialty |
Location | 1911 N 2nd St, Cabot, Arkansas |
Authorized Official Name and Position | Stuart Randall Hill (VP/TREASURER) |
Authorized Official Contact | 5013801004 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
1911 N 2nd St Cabot AR 72023-2209 Ph: (501) 843-5757 | 1911 N 2nd St Cabot AR 72023-2209 Ph: (501) 843-5757 |
NPI Number | 1043700404 |
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Provider Enumeration Date | 05/11/2018 |
Last Update Date | 01/11/2023 |
Identifier | Type | State | Issuer |
---|---|---|---|
1043700404 | NPI | - | NPPES |
229835002 | Medicaid | AR |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
Jerry L Harvey, Do, Pa Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 15361 Highway 5, Suite E, Cabot, AR 72023 Phone: 501-605-9355 | |