| D&d Doctors Pllc | |
|
20602 Arch Street Pike Hensley AR 72065-9442 | |
| (347) 851-0116 | |
| (501) 891-5672 |
| Full Name | D&d Doctors Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 20602 Arch Street Pike, Hensley, Arkansas |
| Authorized Official Name and Position | Sanjay R Dass (MEDICAL DIRECTOR) |
| Authorized Official Contact | 5016260053 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| D&d Doctors Pllc 20602 Arch Street Pike Hensley AR 72065-9442 Ph: (347) 851-0116 | D&d Doctors Pllc 20602 Arch Street Pike Hensley AR 72065-9442 Ph: (347) 851-0116 |
| NPI Number | 1831626183 |
|---|---|
| Provider Enumeration Date | 05/17/2017 |
| Last Update Date | 07/09/2024 |
| Medicare PECOS PAC ID | 5597025163 |
|---|---|
| Medicare Enrollment ID | O20180131001186 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831626183 | NPI | - | NPPES |
| 157860001 | Medicaid | AR | |
| 5N254 | Other | AR | MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QG0300X | Family Medicine - Geriatric Medicine | E4008 (Arkansas) | Secondary |
| 207Q00000X | Family Medicine | E4008 (Arkansas) | Primary |
| Provider Name | Chrystal Dian Johnson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497836563 PECOS PAC ID: 7719872035 Enrollment ID: I20040217000187 |
| Provider Name | Sanjay R Dass |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1265497242 PECOS PAC ID: 2163450560 Enrollment ID: I20050727000840 |
| Provider Name | Courtney J. Fallen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609286780 PECOS PAC ID: 7719103407 Enrollment ID: I20140804000045 |
| Provider Name | Nathan Gerrell Fawbush |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811401193 PECOS PAC ID: 8123389046 Enrollment ID: I20180309000735 |
| Provider Name | Garrett Wade Krisell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215505615 PECOS PAC ID: 8729488333 Enrollment ID: I20210617002303 |
| Provider Name | Lauren Thomas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184238149 PECOS PAC ID: 7517352818 Enrollment ID: I20220324000012 |
| Provider Name | Ann Marie Estes Hodge |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063177426 PECOS PAC ID: 7517353964 Enrollment ID: I20220412000245 |
| Provider Name | Syed Alam |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1073541512 PECOS PAC ID: 6002862224 Enrollment ID: I20241125002273 |
Robert E. Walton, D.o., P.a. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 20798 Arch Street Pike, Hensley, AR 72065 Phone: 501-888-8200 Fax: 501-888-8201 | |
Primary Care 360 Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 21117 Arch St, Hensley, AR 72065 Phone: 870-393-5050 |