| Dr Benjamin M Dodge, MD | |
|
550club Lane, Suite 1, Conway, AR 72034-3681 | |
| (501) 329-1510 | |
| (501) 329-5697 |
| Full Name | Dr Benjamin M Dodge |
|---|---|
| Gender | Male |
| Speciality | Orthopaedic Surgery |
| Location | 550club Lane, Conway, Arkansas |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922090471 | NPI | - | NPPES |
| 123211001 | Medicaid | AR | |
| 12593000000 | Other | AR | QUALCHOICE |
| 200016131 | Other | AR | RR MEDICARE |
| 5J081 | Other | AR | BCBS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207X00000X | Orthopaedic Surgery | C7472 (Arkansas) | Primary |
| Entity Name | South Arkansas Physician Services Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1427018704 PECOS PAC ID: 0749273670 Enrollment ID: O20040406001623 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Benjamin M Dodge, MD 550 Club Ln, Suite 1, Conway, AR 72034-3681 Ph: (501) 329-1510 | Dr Benjamin M Dodge, MD 550club Lane, Suite 1, Conway, AR 72034-3681 Ph: (501) 329-1510 |
Dr. Bryan T Head, M.D. Orthopedic Surgery Medicare: Medicare Enrolled Practice Location: 550 Club Ln Ste 1, Conway, AR 72034 Phone: 501-329-1510 Fax: 501-329-5697 | |
Mr. Robert F Mccarron, M.D. Orthopedic Surgery Medicare: Accepting Medicare Assignments Practice Location: 550 Club Lane, Suite 1, Conway, AR 72034 Phone: 501-329-1510 Fax: 501-329-5697 | |
Dr. James T Howell Jr., MD Orthopedic Surgery Medicare: Accepting Medicare Assignments Practice Location: 550 Club Lane, Suite 1, Conway, AR 72034 Phone: 501-329-1510 Fax: 501-327-2495 | |
Austin Axley Cole, MD Orthopedic Surgery Medicare: Medicare Enrolled Practice Location: 550 Club Ln, Conway, AR 72034 Phone: 501-329-1510 | |
Jordan Matthew Walters, Orthopedic Surgery Medicare: Accepting Medicare Assignments Practice Location: 550 Club Ln Ste 1, Conway, AR 72034 Phone: 501-329-1510 Fax: 501-513-0478 | |
Dr. Harry Scott Smith, M.D. Orthopedic Surgery Medicare: Accepting Medicare Assignments Practice Location: 550 Club Lane, Suite 1, Conway, AR 72034 Phone: 501-329-1510 Fax: 501-329-5697 | |
James Head, MD Orthopedic Surgery Medicare: Accepting Medicare Assignments Practice Location: 550 Club Ln, Conway, AR 72034 Phone: 501-329-1510 Fax: 501-329-5697 |