| Glen F Mcspadden, MD | |
|
1101 Jackson St Sw, Gravette, AR 72736-9121 | |
| (479) 787-5291 | |
| (479) 344-6404 |
| Full Name | Glen F Mcspadden |
|---|---|
| Gender | Male |
| Speciality | Emergency Medicine |
| Location | 1101 Jackson St Sw, Gravette, Arkansas |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487629150 | NPI | - | NPPES |
| 200052620A | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207P00000X | Emergency Medicine | 24242 (Oklahoma) | Secondary |
| 207Q00000X | Family Medicine | E4542 (Arkansas) | Secondary |
| 207P00000X | Emergency Medicine | E4542 (Arkansas) | Primary |
| Entity Name | Southeastern Emergency Physicians Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1356379382 PECOS PAC ID: 2466364997 Enrollment ID: O20050418001201 |
| Entity Name | Washington Regional Medical System |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1306801485 PECOS PAC ID: 8820995434 Enrollment ID: O20051208000082 |
| Entity Name | Sgoh Acquisition Inc |
|---|---|
| Entity Type | Part B Supplier - Hospital Department(s) |
| Entity Identifiers | NPI Number: 1568643005 PECOS PAC ID: 5092616276 Enrollment ID: O20081016000559 |
| Entity Name | South Arkansas Emergency Physicians Llp |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1942435458 PECOS PAC ID: 4486705720 Enrollment ID: O20090629000005 |
| Mailing Address | Practice Location Address |
|---|---|
| Glen F Mcspadden, MD 13763 Colline Rd, Bentonville, AR 72712-9147 Ph: (479) 426-9940 | Glen F Mcspadden, MD 1101 Jackson St Sw, Gravette, AR 72736-9121 Ph: (479) 787-5291 |
Kenneth C. Stewart, D.O. Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 1101 Jackson St Sw, Gravette, AR 72736 Phone: 479-787-5291 | |
Donald Tribbey, D.O. Emergency Medicine Medicare: Medicare Enrolled Practice Location: 1101 Jackson St Sw, Gravette, AR 72736 Phone: 479-787-5291 Fax: 479-344-6404 | |
Steven L. Williams, D.O. Emergency Medicine Medicare: Medicare Enrolled Practice Location: 1101 Jackson St Sw, Gravette, AR 72736 Phone: 479-787-5291 Fax: 479-344-6410 |