| Jerry L Harvey, Do, Pa | |
|
15361 Highway 5 Suite E Cabot AR 72023-5128 | |
| (501) 605-9355 | |
| Not Available |
| Full Name | Jerry L Harvey, Do, Pa |
|---|---|
| Speciality | Clinic/Center |
| Location | 15361 Highway 5, Cabot, Arkansas |
| Authorized Official Name and Position | Jerry Harvey (PRESIDENT) |
| Authorized Official Contact | 5016059355 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jerry L Harvey, Do, Pa 15361 Highway 5 Suite E Cabot AR 72023-5128 Ph: (501) 605-9355 | Jerry L Harvey, Do, Pa 15361 Highway 5 Suite E Cabot AR 72023-5128 Ph: (501) 605-9355 |
| NPI Number | 1477781680 |
|---|---|
| Provider Enumeration Date | 06/25/2009 |
| Last Update Date | 06/25/2009 |
| Medicare PECOS PAC ID | 6800941816 |
|---|---|
| Medicare Enrollment ID | O20090827000027 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477781680 | NPI | - | NPPES |
| 125608003 | Medicaid | AR | |
| 5J444 | Other | AR | MEDICARE ID-TYPE UNSPECIFIED |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Jerry L Harvey |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487602470 PECOS PAC ID: 6608877832 Enrollment ID: I20070130000650 |
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