| 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 | Emergency Medicine |
| Experience | 12 Years |
| Location | 1601 W 40th Ave Ste 100, Pine Bluff, 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 |
|---|---|---|---|
| 1851851992 | NPI | - | NPPES |
| WD933 | Other | FL | HFMG |
| 128727500 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | E-18157 (Arkansas) | Secondary |
| 208M00000X | Hospitalist | ME175460 (Florida) | Primary |
| 207Q00000X | Family Medicine | ME175460 (Florida) | Secondary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Dallas County Medical Center | Fordyce, AR | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Ess Of Fordyce Llc | 1254611601 | 7 |
| Hospital Care Consultants Of Fordyce Llc | 5395024475 | 9 |
| 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 3300 S Fiske Blvd, Rockledge, FL 32955-4306 Ph: (321) 434-1771 | 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 |