| Greenbriar Family Clinic | |
|
49 S Broadview St Ste 1 Greenbrier AR 72058-8011 | |
| (501) 679-4030 | |
| (501) 679-4037 |
| Full Name | Greenbriar Family Clinic |
|---|---|
| Speciality | Family Medicine |
| Location | 49 S Broadview St Ste 1, Greenbrier, Arkansas |
| Authorized Official Name and Position | Will L Rusher (CEO) |
| Authorized Official Contact | 5018127500 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Greenbriar Family Clinic 11001 Executive Center Dr Ste 200 Little Rock AR 72211-4393 Ph: (501) 812-7215 | Greenbriar Family Clinic 49 S Broadview St Ste 1 Greenbrier AR 72058-8011 Ph: (501) 679-4030 |
| NPI Number | 1063705218 |
|---|---|
| Provider Enumeration Date | 05/20/2011 |
| Last Update Date | 04/11/2019 |
| Medicare PECOS PAC ID | 7911802079 |
|---|---|
| Medicare Enrollment ID | O20110718000555 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063705218 | NPI | - | NPPES |
| 188892002 | Medicaid | AR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Gary W Bowman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558473058 PECOS PAC ID: 4183649494 Enrollment ID: I20110125000362 |
| Provider Name | Charles R Clifton |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1366554743 PECOS PAC ID: 1355521055 Enrollment ID: I20110214000273 |
| Provider Name | Jessica R Tackett |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346509478 PECOS PAC ID: 8527371046 Enrollment ID: I20150713002209 |
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