| Lawrence County Family Clinic, Pa | |
|
1210 W Main St Walnut Ridge AR 72476-1005 | |
| (870) 886-3543 | |
| (870) 886-3252 |
| Full Name | Lawrence County Family Clinic, Pa |
|---|---|
| Speciality | Family Medicine |
| Location | 1210 W Main St, Walnut Ridge, Arkansas |
| Authorized Official Name and Position | Karen Patterson (OFFICE MANAGER) |
| Authorized Official Contact | 8708863543 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lawrence County Family Clinic, Pa Po Box 719 Walnut Ridge AR 72476-0719 Ph: (870) 886-3543 | Lawrence County Family Clinic, Pa 1210 W Main St Walnut Ridge AR 72476-1005 Ph: (870) 886-3543 |
| NPI Number | 1942337282 |
|---|---|
| Provider Enumeration Date | 02/27/2007 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 1557347572 |
|---|---|
| Medicare Enrollment ID | O20040629000571 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942337282 | NPI | - | NPPES |
| 56801 | Other | AR | BLUE CROSS BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Clay R Spencer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1255413092 PECOS PAC ID: 0042296071 Enrollment ID: I20040629000620 |
| Provider Name | Sebastian A Spades |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1417021007 PECOS PAC ID: 2062454259 Enrollment ID: I20100312001023 |
| Provider Name | Charles D Davidson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1457425902 PECOS PAC ID: 5890771828 Enrollment ID: I20100624000848 |
| Provider Name | Shawn Peyton |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1124192695 PECOS PAC ID: 7618003575 Enrollment ID: I20100630000612 |
| Provider Name | Nancy J Baltz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578793469 PECOS PAC ID: 3577735679 Enrollment ID: I20111014000330 |
| Provider Name | Cassandra L Hunter |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1003250945 PECOS PAC ID: 5597078139 Enrollment ID: I20160801002203 |
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Lawrence County Family Clinic, Pa Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1210 W Main St, Walnut Ridge, AR 72476 Phone: 870-886-3543 Fax: 870-886-3252 |