| Dr Charles Richard Chamblee Jr, DMIN; MDIV; LAC | |
|
11321 Interstate 30, Suite 304, Little Rock, AR 72209-7067 | |
| (501) 202-7587 | |
| (501) 202-7513 |
| Full Name | Dr Charles Richard Chamblee Jr |
|---|---|
| Gender | Male |
| Speciality | Counselor - Professional |
| Location | 11321 Interstate 30, Little Rock, Arkansas |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285979609 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | A1203022 (Arkansas) | Primary |
| Entity Name | Arkansas Health Group |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1871959874 PECOS PAC ID: 7911802079 Enrollment ID: O20141029001863 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Charles Richard Chamblee Jr, DMIN; MDIV; LAC 11001 Executive Center Dr Ste 200, Little Rock, AR 72211-4393 Ph: (501) 202-7587 | Dr Charles Richard Chamblee Jr, DMIN; MDIV; LAC 11321 Interstate 30, Suite 304, Little Rock, AR 72209-7067 Ph: (501) 202-7587 |
Crystal Ann Mcmullen, Counselor Medicare: Not Enrolled in Medicare Practice Location: 5918 Lee Ave, Little Rock, AR 72205 Phone: 501-669-2199 | |
Colleen Stone, MHPP Counselor Medicare: Not Enrolled in Medicare Practice Location: 20400 Col Glenn Rd, Little Rock, AR 72210 Phone: 501-821-5500 | |
Mrs. Adrienne Reeves, L.P.E. Counselor Medicare: Not Enrolled in Medicare Practice Location: 1900 Aldersgate Rd, Little Rock, AR 72205 Phone: 501-821-5459 Fax: 501-821-6116 | |
Chris Beasley, Counselor Medicare: Not Enrolled in Medicare Practice Location: 9819 Margie Cir, Little Rock, AR 72209 Phone: 501-319-2521 | |
David Laser Jr., BS, MBA, CIT Counselor Medicare: Not Enrolled in Medicare Practice Location: 3700 W 65th St, Little Rock, AR 72209 Phone: 479-806-0469 | |
Crystal Goins, QBHP Counselor Medicare: Not Enrolled in Medicare Practice Location: 20400 Colonel Glenn Rd, Little Rock, AR 72210 Phone: 501-821-5500 | |
Mr. Michael Ekdahl, LPE-I Counselor Medicare: Not Enrolled in Medicare Practice Location: 5800 West 10th Street, Suite 600, Little Rock, AR 72204 Phone: 501-660-6817 Fax: 501-660-6825 |