| Paul Vellozo, MD | |
|
1309 West Main St, Family Medical Center, Walnut Ridge, AR 72476-0839 | |
| (870) 886-3211 | |
| (870) 886-9027 |
| Full Name | Paul Vellozo |
|---|---|
| Gender | Male |
| Speciality | Internal Medicine |
| Experience | 36 Years |
| Location | 1309 West Main St, Walnut Ridge, 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 |
|---|---|---|---|
| 1386744274 | NPI | - | NPPES |
| 128860001 | Medicaid | AR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | E0629 (Arkansas) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Lawrence Memorial Hospital | Walnut ridge, AR | Hospital |
| St Bernards Medical Center | Jonesboro, AR | Hospital |
| Lawrence Hall Health & Rehabilitation | Walnut ridge, AR | Nursing home |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| St Bernards Hospital Inc. | 0941105480 | 166 |
| Lawrence Memorial Hospital | 9436052917 | 9 |
| Lawrence Memorial Health Foundation Inc | 9436305836 | 10 |
| Entity Name | St Bernards Hospital Inc. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1336150374 PECOS PAC ID: 0941105480 Enrollment ID: O20050121000843 |
| Entity Name | St Bernards Hospital Inc. |
|---|---|
| Entity Type | Part B Supplier - Hospital Department(s) |
| Entity Identifiers | NPI Number: 1518327287 PECOS PAC ID: 0941105480 Enrollment ID: O20070718000531 |
| Entity Name | Lawrence Hall Nursing Center |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1649343195 PECOS PAC ID: 8921253394 Enrollment ID: O20131119000157 |
| Entity Name | St Bernards Hospital Inc. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1891178828 PECOS PAC ID: 0941105480 Enrollment ID: O20150824001158 |
| Entity Name | Lawrence Memorial Health Foundation Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1528052107 PECOS PAC ID: 9436305836 Enrollment ID: O20191029002135 |
| Entity Name | Lawrence Memorial Health Foundation Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1962626770 PECOS PAC ID: 9436305836 Enrollment ID: O20191030002298 |
| Mailing Address | Practice Location Address |
|---|---|
| Paul Vellozo, MD Po Box 839, Walnut Ridge, AR 72476-0839 Ph: (870) 886-3211 | Paul Vellozo, MD 1309 West Main St, Family Medical Center, Walnut Ridge, AR 72476-0839 Ph: (870) 886-3211 |
Mrs. Samantha L. Hatfield, M.D. Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 1309 West Main Street, Walnut Ridge, AR 72476 Phone: 870-886-3211 Fax: 870-886-9027 |