| Kyle Kreulen, | |
|
3714 Grand Oaks Dr, Benton, AR 72019-2045 | |
| (501) 517-7004 | |
| Not Available |
| Full Name | Kyle Kreulen |
|---|---|
| Gender | Male |
| Speciality | Physician Assistant |
| Location | 3714 Grand Oaks Dr, Benton, Arkansas |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912463902 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | PA-907 (Arkansas) | Primary |
| 207RR0500X | Internal Medicine - Rheumatology | PA-907 (Arkansas) | Secondary |
| Entity Name | Uhs of Benton LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1063482735 PECOS PAC ID: 3173513504 Enrollment ID: O20070726000853 |
| Mailing Address | Practice Location Address |
|---|---|
| Kyle Kreulen, 3714 Grand Oaks Dr, Benton, AR 72019-2045 Ph: (501) 517-7004 | Kyle Kreulen, 3714 Grand Oaks Dr, Benton, AR 72019-2045 Ph: (501) 517-7004 |
Mr. Matthew H Pruitt, P.A.-C Physician Assistant Medicare: Medicare Enrolled Practice Location: 1 Medical Park Dr, Benton, AR 72015 Phone: 501-776-6000 |
Bridget Catherine O'leary, PA-C Physician Assistant Medicare: Medicare Enrolled Practice Location: 105 Mcneil St, Benton, AR 72015 Phone: 501-315-1222 |
Ashley Delo, PA Physician Assistant Medicare: Medicare Enrolled Practice Location: 105 Mcneil St, Benton, AR 72015 Phone: 501-315-1222 |
Jasmin Ann Lease, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 2010 Active Way, Benton, AR 72019 Phone: 501-315-0984 Fax: 501-847-1405 |
David M Street, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 2010 Active Way, Benton, AR 72022 Phone: 501-315-0984 Fax: 501-847-1405 |
Mrs. Natalie Shea Bradford, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 819 W Carpenter St, Benton, AR 72015 Phone: 501-778-8264 Fax: 501-778-7360 |
Tyler L Childs, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 1000 Hwy 35 N Ste 8, Benton, AR 72019 Phone: 501-315-4008 Fax: 501-315-3411 |