| Khaled Abdalla Matar, MD | |
| 
					1601 W 40th Ave Ste 100, Pine Bluff, AR 71603-6069  | |
| (870) 541-6010 | |
| Not Available | 
| Full Name | Khaled Abdalla Matar | 
|---|---|
| Gender | Male | 
| Speciality | Hospitalist | 
| Location | 1601 W 40th Ave Ste 100, Pine Bluff, Arkansas | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1851851992 | NPI | - | NPPES | 
| PENDING | Medicaid | FL | |
| PENDING | Other | FL | HFMG | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 208M00000X | Hospitalist | ME175460 (Florida) | Primary | 
| 207Q00000X | Family Medicine | ME175460 (Florida) | Secondary | 
| 207Q00000X | Family Medicine | E-18157 (Arkansas) | Secondary | 
| Entity Name | Arkansas Emergency Staffing Solutions Inc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1275774630 PECOS PAC ID: 3274681341 Enrollment ID: O20090501000014  | 
| Entity Name | Hospital Care Consultants Of Fordyce Llc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1316497464 PECOS PAC ID: 5395024475 Enrollment ID: O20161112000042  | 
| Entity Name | Ess Of Fordyce Llc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1821547977 PECOS PAC ID: 1254611601 Enrollment ID: O20161201001070  | 
| Entity Name | Ess Of Mcgehee Llc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1639822653 PECOS PAC ID: 0749677516 Enrollment ID: O20220426000293  | 
| Mailing Address | Practice Location Address | 
|---|---|
| Khaled Abdalla Matar, MD 13021 Terrace Springs Dr, Temple Terrace, FL 33637-3007 Ph: (813) 373-4143  | Khaled Abdalla Matar, MD 1601 W 40th Ave Ste 100, Pine Bluff, AR 71603-6069 Ph: (870) 541-6010  | 
Carla Yvonne Pumphrey, MD Hospitalist Medicare: Accepting Medicare Assignments Practice Location: 4010 S Mulberry St, Pine Bluff, AR 71603 Phone: 870-541-6000  |