| Ouachita Valley Family Practice/a Baptist Affiliate | |
|
353 Cash Rd Sw Camden AR 71701-3704 | |
| (870) 836-8101 | |
| (870) 837-6833 |
| Full Name | Ouachita Valley Family Practice/a Baptist Affiliate |
|---|---|
| Speciality | Clinic/Center |
| Location | 353 Cash Rd Sw, Camden, Arkansas |
| Authorized Official Name and Position | Will 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 |
|---|---|
| Ouachita Valley Family Practice/a Baptist Affiliate Po Box 757 Camden AR 71711-0757 Ph: (870) 836-8101 | Ouachita Valley Family Practice/a Baptist Affiliate 353 Cash Rd Sw Camden AR 71701-3704 Ph: (870) 836-8101 |
| NPI Number | 1538132402 |
|---|---|
| Provider Enumeration Date | 02/09/2006 |
| Last Update Date | 08/30/2023 |
| Medicare PECOS PAC ID | 7911802079 |
|---|---|
| Medicare Enrollment ID | O20040121000189 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538132402 | NPI | - | NPPES |
| 128619002 | Medicaid | AR | |
| 5B779 | Other | AR | BLUE CROSS BLUE SHIELD |
| 770001002 | Other | AR | BREASTCARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
| Provider Name | Milton Brunson |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1447227244 PECOS PAC ID: 9931192374 Enrollment ID: I20040403000083 |
| Provider Name | Johnathan W Lewis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1699741298 PECOS PAC ID: 7214911627 Enrollment ID: I20040615000200 |
| Provider Name | Andrew G Kumpuris |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1669483293 PECOS PAC ID: 1254319270 Enrollment ID: I20040707001404 |
| Provider Name | Joseph A Deluca |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1417969478 PECOS PAC ID: 9335146844 Enrollment ID: I20061025000752 |
| Provider Name | David H Mosley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1619943271 PECOS PAC ID: 9335274919 Enrollment ID: I20100322000415 |
| Provider Name | Lawrence F Braden |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447223060 PECOS PAC ID: 6507991064 Enrollment ID: I20100323000342 |
| Provider Name | Judson N Hout |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932183142 PECOS PAC ID: 2163559469 Enrollment ID: I20100419000281 |
| Provider Name | Mark R Crump |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578530366 PECOS PAC ID: 1456489582 Enrollment ID: I20100512000086 |
| Provider Name | William D Dedman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750342804 PECOS PAC ID: 6002945672 Enrollment ID: I20100520000693 |
| Provider Name | Nicole Critton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700244985 PECOS PAC ID: 4587711130 Enrollment ID: I20160404000887 |
| Provider Name | Stephanie M Dunn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578000287 PECOS PAC ID: 2062796170 Enrollment ID: I20170308001223 |
| Provider Name | Melanie L Hearnsberger Mcguire |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760996276 PECOS PAC ID: 5799044475 Enrollment ID: I20180126000258 |
| Provider Name | Chelsea J Bounds |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033626585 PECOS PAC ID: 6507120508 Enrollment ID: I20180427000438 |
| Provider Name | Brittany Brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750846739 PECOS PAC ID: 2163762295 Enrollment ID: I20190327000997 |
| Provider Name | Tomekia S White |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992192769 PECOS PAC ID: 8628398393 Enrollment ID: I20190628000843 |
| Provider Name | Harlee A Pennington |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114658291 PECOS PAC ID: 1658751813 Enrollment ID: I20220706000216 |
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