| Dr Venkata Surya Phani Bhushan Durvasula, MD | |
|
403 W Oak St Ste 105, El Dorado, AR 71730-4573 | |
| (870) 639-8105 | |
| (870) 639-8109 |
| Full Name | Dr Venkata Surya Phani Bhushan Durvasula |
|---|---|
| Gender | Male |
| Speciality | Otolaryngology |
| Experience | 32 Years |
| Location | 403 W Oak St Ste 105, El Dorado, 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 |
|---|---|---|---|
| 1770861478 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Y00000X | Otolaryngology | E-7645 (Arkansas) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Medical Center Of South Arkansas | El dorado, AR | Hospital |
| Ouachita County Medical Center | Camden, AR | Hospital |
| Entity Name | University Of Arkansas For Medical Sciences |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1346230968 PECOS PAC ID: 4082528955 Enrollment ID: O20040115000431 |
| 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 |
| Entity Name | Jaiarka Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1730844168 PECOS PAC ID: 5991197576 Enrollment ID: O20220111000287 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Venkata Surya Phani Bhushan Durvasula, MD 403 W Oak St Ste 105, El Dorado, AR 71730-4573 Ph: (870) 639-8105 | Dr Venkata Surya Phani Bhushan Durvasula, MD 403 W Oak St Ste 105, El Dorado, AR 71730-4573 Ph: (870) 639-8105 |
Sharon Marie Tomaski, MD Otolaryngology Medicare: Medicare Enrolled Practice Location: 620 W Grove St Ste 201, El Dorado, AR 71730 Phone: 870-864-3352 Fax: 870-864-3255 |