| James Roy Crouch Jr, MD | |
|
1808 W Main St, Russellville, AR 72801-2724 | |
| (479) 964-4178 | |
| (479) 964-5910 |
| Full Name | James Roy Crouch Jr |
|---|---|
| Gender | Male |
| Speciality | Hospitalist |
| Location | 1808 W Main St, Russellville, Arkansas |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437115508 | NPI | - | NPPES |
| 121448001 | Medicaid | AR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208M00000X | Hospitalist | C-7680 (Arkansas) | Primary |
| 207Q00000X | Family Medicine | C-7680 (Arkansas) | Secondary |
| Entity Name | St Marys Physician Services Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1124084991 PECOS PAC ID: 4981698032 Enrollment ID: O20040609000759 |
| Entity Name | Mercy Clinic Fort Smith Communities |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1902073620 PECOS PAC ID: 3870668510 Enrollment ID: O20080814000789 |
| Mailing Address | Practice Location Address |
|---|---|
| James Roy Crouch Jr, MD 101 Skyline Dr, Russellville, AR 72801-3363 Ph: (479) 968-2345 | James Roy Crouch Jr, MD 1808 W Main St, Russellville, AR 72801-2724 Ph: (479) 964-4178 |
Chaitanya Korrapati, M.D. Hospitalist Medicare: Medicare Enrolled Practice Location: 1808 W Main St, Russellville, AR 72801 Phone: 479-964-4178 Fax: 479-964-5910 | |
Dr. Muska Ullah, MD Hospitalist Medicare: Accepting Medicare Assignments Practice Location: 1808 W Main St, Russellville, AR 72801 Phone: 479-964-4178 Fax: 479-964-5910 |