| Dylan Paul Thaxton, MD | |
|
2223 Grant St, Malvern, AR 72104-4700 | |
| (501) 337-9031 | |
| (501) 337-9033 |
| Full Name | Dylan Paul Thaxton |
|---|---|
| Gender | Male |
| Speciality | Family Medicine |
| Location | 2223 Grant St, Malvern, Arkansas |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609040849 | NPI | - | NPPES |
| 170953001 | Medicaid | AR | |
| 1609040849 | Medicaid | MO | |
| 200594090 A | Medicaid | KS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 2007018509 (Missouri) | Secondary |
| 207Q00000X | Family Medicine | E5683 (Arkansas) | Primary |
| Entity Name | Arkansas Heart Hospital Rural Health Services, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1548553811 PECOS PAC ID: 6204004815 Enrollment ID: O20110727000090 |
| Entity Name | Arkansas Heart Hospital Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1558653212 PECOS PAC ID: 6002838653 Enrollment ID: O20110729000327 |
| Entity Name | Direct Md Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1457077356 PECOS PAC ID: 5395116941 Enrollment ID: O20230119000562 |
| Mailing Address | Practice Location Address |
|---|---|
| Dylan Paul Thaxton, MD 2223 Grant St, Malvern, AR 72104-4700 Ph: (501) 337-9031 | Dylan Paul Thaxton, MD 2223 Grant St, Malvern, AR 72104-4700 Ph: (501) 337-9031 |
Ms. Melanie Deborah Jones, M.D. Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 1001 Schneider Dr, Malvern, AR 72104 Phone: 501-332-1000 | |
Dr. Gregory Scott Mckinney, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 100 Walco Ln, Malvern, AR 72104 Phone: 501-337-8061 Fax: 501-337-8043 | |
Dr. Vivian Faye Highsmith, MD Family Medicine Medicare: Medicare Enrolled Practice Location: 1001 Schneider Dr, Malvern, AR 72104 Phone: 501-332-7355 Fax: 501-332-7044 | |
Omar Qazi, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1001 Schneider Dr, Malvern, AR 72104 Phone: 501-332-1000 | |
Larry Bruce Brashears, M.D. Family Medicine Medicare: Medicare Enrolled Practice Location: 1517 S Main St, Malvern, AR 72104 Phone: 501-332-7525 | |
Shawn Purifoy, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 850 Henry St, Malvern, AR 72104 Phone: 501-337-1836 Fax: 501-337-7935 |