| Pat Walker Health Center | |
|
525 N Garland Ave Fayetteville AR 72701-3110 | |
| (479) 575-6479 | |
| Not Available |
| Full Name | Pat Walker Health Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 525 N Garland Ave, Fayetteville, Arkansas |
| Authorized Official Name and Position | Anjanette Olsen (DIRECTOR OF MEDICAL SERVICES) |
| Authorized Official Contact | 4795754476 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pat Walker Health Center 525 N Garland Ave 1 University Of Arkansas Fayetteville AR 72701-3110 Ph: (479) 575-6479 | Pat Walker Health Center 525 N Garland Ave Fayetteville AR 72701-3110 Ph: (479) 575-6479 |
| NPI Number | 1619908787 |
|---|---|
| Provider Enumeration Date | 07/06/2006 |
| Last Update Date | 03/26/2024 |
| Medicare PECOS PAC ID | 1951391630 |
|---|---|
| Medicare Enrollment ID | O20120309000551 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619908787 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| 261QS1000X | Clinic/center - Student Health | (* (Not Available)) | Secondary |
| Provider Name | David Beck |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1104872969 PECOS PAC ID: 5799788105 Enrollment ID: I20060824000031 |
| Provider Name | Susan Md Raben-taylor |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1780613489 PECOS PAC ID: 1658373329 Enrollment ID: I20070208000464 |
| Provider Name | Robert R Pang |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1437251642 PECOS PAC ID: 8325144017 Enrollment ID: I20070425000592 |
| Provider Name | Huda Sharaf |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1912043043 PECOS PAC ID: 3779652714 Enrollment ID: I20080516000678 |
| Provider Name | Carlos A Acosta |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689879777 PECOS PAC ID: 6406914720 Enrollment ID: I20100830000591 |
| Provider Name | Deborah Deere |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538331962 PECOS PAC ID: 1456520311 Enrollment ID: I20110810000041 |
| Provider Name | Ramon C Ylanan |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1497841530 PECOS PAC ID: 7214029206 Enrollment ID: I20120221000939 |
| Provider Name | Tina Goodson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1467650358 PECOS PAC ID: 4789803669 Enrollment ID: I20140909001149 |
| Provider Name | Larry Balle |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1508283995 PECOS PAC ID: 1456634542 Enrollment ID: I20180613001850 |
| Provider Name | Hannah Rae Lamm |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912548058 PECOS PAC ID: 5698007615 Enrollment ID: I20191024001246 |
| Provider Name | Lauren K Poindexter |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1982082038 PECOS PAC ID: 4587956719 Enrollment ID: I20210910002719 |
| Provider Name | Abigail Elizabeth Deangelis |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1740852110 PECOS PAC ID: 3678978988 Enrollment ID: I20230427001285 |
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