Wood Md Pa | |
1605 W Main St Russellville AR 72801-2719 | |
(479) 219-5008 | |
(479) 219-5028 |
Full Name | Wood Md Pa |
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Speciality | Family Medicine |
Location | 1605 W Main St, Russellville, Arkansas |
Authorized Official Name and Position | Lavon Jeneen Wood (PRESIDEN) |
Authorized Official Contact | 4792195008 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Wood Md Pa 1605 W Main St Russellville AR 72801-2719 Ph: (479) 219-5008 | Wood Md Pa 1605 W Main St Russellville AR 72801-2719 Ph: (479) 219-5008 |
NPI Number | 1447775192 |
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Provider Enumeration Date | 08/03/2017 |
Last Update Date | 07/25/2022 |
Medicare PECOS PAC ID | 8426324039 |
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Medicare Enrollment ID | O20171026002090 |
Identifier | Type | State | Issuer |
---|---|---|---|
1447775192 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | Tammy Lusk |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1457525909 PECOS PAC ID: 9133294515 Enrollment ID: I20080819000967 |
Provider Name | Lavon J Wood |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1427251776 PECOS PAC ID: 1355473091 Enrollment ID: I20100716000105 |
Provider Name | Sallie M Hampton |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1447460993 PECOS PAC ID: 0143451906 Enrollment ID: I20140320001874 |
Provider Name | Jennifer M Harris |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1588053789 PECOS PAC ID: 3173841798 Enrollment ID: I20150410002322 |
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 | |
St Mary's Physician Services Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 101 Skyline Dr, Russellville, AR 72801 Phone: 479-968-2345 Fax: 479-890-2497 | |
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 |