| Mr Daniel C Black, PA | |
|
603 N Progress Ave, Siloam Springs, AR 72761-4352 | |
| (479) 524-4141 | |
| (479) 549-2577 |
| Full Name | Mr Daniel C Black |
|---|---|
| Gender | Male |
| Speciality | Physician Assistant |
| Location | 603 N Progress Ave, Siloam Springs, Arkansas |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699270140 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | PT2018-017 (Arkansas) | Primary |
| Entity Name | Southeastern Emergency Physicians LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1356379382 PECOS PAC ID: 2466364997 Enrollment ID: O20050418001201 |
| Entity Name | South Arkansas Emergency Physicians LLP |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1942435458 PECOS PAC ID: 4486705720 Enrollment ID: O20090629000005 |
| Entity Name | Ies Arkansas PLLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1598488090 PECOS PAC ID: 6204207665 Enrollment ID: O20230123000050 |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Daniel C Black, PA 200 Corporate Blvd, Lafayette, LA 70508-3870 Ph: (800) 893-9698 | Mr Daniel C Black, PA 603 N Progress Ave, Siloam Springs, AR 72761-4352 Ph: (479) 524-4141 |
Daniel Shane Briley, PA Physician Assistant Medicare: Medicare Enrolled Practice Location: 2125 E Main St Ste 10, Siloam Springs, AR 72761 Phone: 479-524-8552 Fax: 479-524-8593 |
Mrs. Jamie Janelle Claborn, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 2033 Ravenwood Plaza, Siloam Springs, AR 72761 Phone: 479-373-6566 Fax: 479-373-6567 |
Mary Emily Featherstone, Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 451 S Holly St, Siloam Springs, AR 72761 Phone: 479-549-3079 Fax: 479-549-3275 |
Ms. Rachel Fritsche Gordon, PA-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: Northwest Health Urgent Care-siloam Springs, 3721 Us-412, Siloam Springs, AR 72761 Phone: 479-215-3080 Fax: 713-794-8875 |
Ms. Mary Melinda Ericson, P.A. Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 3721 E Us 412 Hwy Ste B, Siloam Springs, AR 72761 Phone: 479-215-3080 Fax: 479-549-4059 |
Lindsay Turner, PA-C Physician Assistant Medicare: Medicare Enrolled Practice Location: 1101 N Progress Ave Ste 2, Siloam Springs, AR 72761 Phone: 479-549-4228 Fax: 479-549-3711 |
Maurice Anthony Jones, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 500 S Mount Olive St, Suite 200, Siloam Springs, AR 72761 Phone: 479-524-6357 Fax: 479-524-9552 |