| Advanced Dermatology & Skin Cancer Center, Llc | |
|
1444 E Stearns St Suite 11 Fayetteville AR 72703-6243 | |
| (479) 718-7546 | |
| (479) 966-4979 |
| Full Name | Advanced Dermatology & Skin Cancer Center, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1444 E Stearns St, Fayetteville, Arkansas |
| Authorized Official Name and Position | Lance Brandon Henry (DIRECTOR) |
| Authorized Official Contact | 4798568494 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Advanced Dermatology & Skin Cancer Center, Llc 1444 E Stearns St Suite 11 Fayetteville AR 72703-6243 Ph: (479) 718-7546 | Advanced Dermatology & Skin Cancer Center, Llc 1444 E Stearns St Suite 11 Fayetteville AR 72703-6243 Ph: (479) 718-7546 |
| NPI Number | 1245426162 |
|---|---|
| Provider Enumeration Date | 09/25/2007 |
| Last Update Date | 08/02/2021 |
| Medicare PECOS PAC ID | 2961588900 |
|---|---|
| Medicare Enrollment ID | O20080401000019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245426162 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Cyril E Severns |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1013904176 PECOS PAC ID: 1052389491 Enrollment ID: I20040922001138 |
| Provider Name | Lance Henry |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1679682520 PECOS PAC ID: 8921184979 Enrollment ID: I20080401000087 |
| Provider Name | Emily L Staggs |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053606145 PECOS PAC ID: 1456523166 Enrollment ID: I20140403000404 |
| Provider Name | Joseph Allen Blackmon |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1003133901 PECOS PAC ID: 0345465621 Enrollment ID: I20180925000272 |
| Provider Name | Linsey Lindley |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1912439720 PECOS PAC ID: 2466720545 Enrollment ID: I20210713000908 |
| Provider Name | Nathan Merritt Johnson |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1942731674 PECOS PAC ID: 3779856026 Enrollment ID: I20210722000596 |
Community Clinic Fayetteville Medical Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 3162 W Martin Luther King Blvd, Suites 13 & 14, Fayetteville, AR 72704 Phone: 479-935-4834 Fax: 479-751-2878 | |
K E Management Services Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1420 E Augustine Ln Ste 7, Fayetteville, AR 72703 Phone: 479-200-9812 Fax: 866-243-7203 | |
Bryan Abernathy Md Pa Dba Abernathy Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1806 N Crossover Rd, Suite 4, Fayetteville, AR 72701 Phone: 479-521-5603 Fax: 479-521-5773 | |
Truhealth Family Care Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2630 E Citizens Dr, Suite 3, Fayetteville, AR 72703 Phone: 479-527-9966 Fax: 479-527-9677 | |
Washington County Hiv Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 3270 N. Wimberly Drive, Fayetteville, AR 72703 Phone: 479-973-8450 Fax: 479-973-8452 | |
Dr James Dunn Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 4368 E Churchill Dr, Fayetteville, AR 72701 Phone: 479-442-4553 Fax: 479-251-1006 | |
Rediclinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3911 North Mall Avenue, Fayetteville, AR 72703 Phone: 866-706-6334 Fax: 713-358-4801 |