| Mr Michael Burnett, PA-C | |
|
1090 Arnold Dr, Little Rock Afb, AR 72099-4933 | |
| (501) 987-2932 | |
| Not Available |
| Full Name | Mr Michael Burnett |
|---|---|
| Gender | Male |
| Speciality | Physician Assistant |
| Location | 1090 Arnold Dr, Little Rock Afb, Arkansas |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811469604 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | PA2024-0091 (New Mexico) | Primary |
| 363A00000X | Physician Assistant | 11690304-1206 (Utah) | Secondary |
| Entity Name | Fedko Emergency Physicians New Mexico, LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1770047441 PECOS PAC ID: 4880934389 Enrollment ID: O20190320001146 |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Michael Burnett, PA-C 1090 Arnold Dr, Little Rock Afb, AR 72099-4933 Ph: (501) 987-2932 | Mr Michael Burnett, PA-C 1090 Arnold Dr, Little Rock Afb, AR 72099-4933 Ph: (501) 987-2932 |
Patrick Depriest, PA-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 1090 Arnold Dr, Little Rock Afb, AR 72099 Phone: 501-987-2932 |
Neoni S Yustana, Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 1090 Arnold Dr, Little Rock Afb, AR 72099 Phone: 501-987-2932 |
Yoohyun Song, Physician Assistant Medicare: Medicare Enrolled Practice Location: 1090 Arnold Dr, Little Rock Afb, AR 72099 Phone: 501-987-3080 |
Sonja Renee Collier Martin, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 1090 Arnold Dr, Little Rock Afb, AR 72099 Phone: 501-987-7319 |
Ashley Jean Green, PA Physician Assistant Medicare: Medicare Enrolled Practice Location: 1090 Arnold Dr, Little Rock Afb, AR 72099 Phone: 501-987-8811 |
Andrew Tishim, Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 1090 Arnold Dr, Little Rock Afb, AR 72099 Phone: 501-987-2932 |
James Steven Bryant, Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 1090 Arnold Dr, Little Rock Afb, AR 72099 Phone: 501-987-8811 |