| Dr Randall Wayne Black, MD | |
|
5204 W Redbud Street, Rogers, AR 72758 | |
| (479) 636-0110 | |
| (479) 631-0491 |
| Full Name | Dr Randall Wayne Black |
|---|---|
| Gender | Male |
| Speciality | Otolaryngology |
| Experience | 37 Years |
| Location | 5204 W Redbud Street, Rogers, Arkansas |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942268909 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Y00000X | Otolaryngology | C7458 (Arkansas) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Mercy Hospital Northwest Arkansas | Rogers, AR | Hospital |
| Mercy Hospital Berryville | Berryville, AR | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Mercy Health Northwest Arkansas Communities | 0648177873 | 296 |
| Entity Name | Mercy Health Northwest Arkansas Communities |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1265490916 PECOS PAC ID: 0648177873 Enrollment ID: O20031216000788 |
| Entity Name | Mercy Health Northwest Arkansas Communities |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1508167677 PECOS PAC ID: 0648177873 Enrollment ID: O20110302000405 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Randall Wayne Black, MD 5204 W Redbud Street, Rogers, AR 72758 Ph: (479) 636-0110 | Dr Randall Wayne Black, MD 5204 W Redbud Street, Rogers, AR 72758 Ph: (479) 636-0110 |
Matthew Bridges, MD Otolaryngology Medicare: Accepting Medicare Assignments Practice Location: 5204 W Redbud St, Rogers, AR 72758 Phone: 479-636-0110 | |
Dr. John Reed Lee, MD Otolaryngology Medicare: Accepting Medicare Assignments Practice Location: 5204 W Redbud St, Rogers, AR 72758 Phone: 479-636-0110 Fax: 479-631-0491 | |
Chad W Putman, MD Otolaryngology Medicare: Accepting Medicare Assignments Practice Location: 5204 W Redbud St, Rogers, AR 72758 Phone: 479-636-0110 Fax: 479-636-0491 |