| Gregory Wayne Mallard, MD | |
|
425 W Jackson St, Piggott, AR 72454-1538 | |
| (870) 598-2236 | |
| (870) 598-3080 |
| Full Name | Gregory Wayne Mallard |
|---|---|
| Gender | Male |
| Speciality | Family Practice |
| Experience | 27 Years |
| Location | 425 W Jackson St, Piggott, 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 |
|---|---|---|---|
| 1235146846 | NPI | - | NPPES |
| 140508001 | Medicaid | AR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | E2399 (Arkansas) | Secondary |
| 207Q00000X | Family Medicine | 0101265974 (Virginia) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Continuum Home Health Care | Charlottesville, VA | Home health agency |
| Sentara Home Care Services | Charlottesville, VA | Home health agency |
| Sentara Martha Jefferson Hospital | Charlottesville, VA | Hospital |
| Novant Health Uva Health System Culpeper Med Cente | Culpeper, VA | Hospital |
| University Of Virginia Medical Center | Charlottesville, VA | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Martha Jefferson Medical Group Llc | 5991889081 | 170 |
| Entity Name | Martha Jefferson Medical Group Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1275720559 PECOS PAC ID: 5991889081 Enrollment ID: O20080228000055 |
| Mailing Address | Practice Location Address |
|---|---|
| Gregory Wayne Mallard, MD 140 Stoneridge Dr S Ste 100, Ruckersville, VA 22968-3096 Ph: (434) 654-1850 | Gregory Wayne Mallard, MD 425 W Jackson St, Piggott, AR 72454-1538 Ph: (870) 598-2236 |
James G Sheridan, M.D. Family Medicine Medicare: Medicare Enrolled Practice Location: 425 W Jackson St, Piggott, AR 72454 Phone: 870-598-2236 Fax: 870-598-3080 | |
Dennis N Blake, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 425 W Jackson St, Piggott, AR 72454 Phone: 870-598-2236 Fax: 870-598-3080 | |
Dr. Jt Dewitt Jr., D.O. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1206 Gordon Duckworth Dr, Piggott, AR 72454 Phone: 870-598-3881 Fax: 870-598-5716 |