| Ozark Pediatrics Pllc | |
|
5507 W Walsh Ln Ste 101 Rogers AR 72758-9007 | |
| (479) 544-9432 | |
| (479) 544-9443 |
| Full Name | Ozark Pediatrics Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 5507 W Walsh Ln Ste 101, Rogers, Arkansas |
| Authorized Official Name and Position | Craig Eugene Keever (OWNER) |
| Authorized Official Contact | 4795449432 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ozark Pediatrics Pllc 5507 W Walsh Ln Ste 101 Rogers AR 72758-9007 Ph: (479) 544-9432 | Ozark Pediatrics Pllc 5507 W Walsh Ln Ste 101 Rogers AR 72758-9007 Ph: (479) 544-9432 |
| NPI Number | 1326592841 |
|---|---|
| Provider Enumeration Date | 08/12/2016 |
| Last Update Date | 09/22/2016 |
| Medicare PECOS PAC ID | 4688955263 |
|---|---|
| Medicare Enrollment ID | O20161220001744 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326592841 | NPI | - | NPPES |
| 146352001 | Medicaid | AR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | E3170 (Arkansas) | Primary |
| Provider Name | Craig E Keever |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1730122102 PECOS PAC ID: 0547492514 Enrollment ID: I20140407001880 |
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