| Doctors Health Group, Inc. | |
|
800 S Church St Ste 203 Jonesboro AR 72401-4106 | |
| (870) 934-1462 | |
| (870) 932-5699 |
| Full Name | Doctors Health Group, Inc. |
|---|---|
| Speciality | Dermatology |
| Location | 800 S Church St Ste 203, Jonesboro, Arkansas |
| Authorized Official Name and Position | John Lieblong (PRESIDENT) |
| Authorized Official Contact | 8709327024 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Doctors Health Group, Inc. Po Box 1331 Jonesboro AR 72403-1331 Ph: (870) 932-7024 | Doctors Health Group, Inc. 800 S Church St Ste 203 Jonesboro AR 72401-4106 Ph: (870) 934-1462 |
| NPI Number | 1306366885 |
|---|---|
| Provider Enumeration Date | 06/26/2017 |
| Last Update Date | 11/19/2021 |
| Medicare PECOS PAC ID | 7315844586 |
|---|---|
| Medicare Enrollment ID | O20170830002507 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306366885 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
| 207N00000X | Dermatology | (* (Not Available)) | Primary |
| Provider Name | Mallory Dell Hurst |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1710229141 PECOS PAC ID: 0648403485 Enrollment ID: I20170830002984 |
| Provider Name | Colton B Nielson |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1699122507 PECOS PAC ID: 7618264755 Enrollment ID: I20210712003993 |
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