| South Arkansas Physician Services Llc | |
|
700 W Grove St El Dorado AR 71730-4416 | |
| (870) 863-2000 | |
| Not Available |
| Full Name | South Arkansas Physician Services Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 700 W Grove St, El Dorado, Arkansas |
| Authorized Official Name and Position | Jennifer L Jackson (SR. DIRECTOR PROVIDER ENROLLMENT) |
| Authorized Official Contact | 8778929815 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| South Arkansas Physician Services Llc 7100 Commerce Way Suite 180 Brentwood TN 37027-2829 Ph: (615) 465-7000 | South Arkansas Physician Services Llc 700 W Grove St El Dorado AR 71730-4416 Ph: (870) 863-2000 |
| NPI Number | 1427018704 |
|---|---|
| Provider Enumeration Date | 03/23/2006 |
| Last Update Date | 03/05/2022 |
| Medicare PECOS PAC ID | 0749273670 |
|---|---|
| Medicare Enrollment ID | O20040406001623 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427018704 | NPI | - | NPPES |
| 145507002 | Medicaid | AR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
| 363L00000X | Nurse Practitioner | (* (Not Available)) | Secondary |
| Provider Name | Martha G Garrett Shaver |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740274448 PECOS PAC ID: 8527971159 Enrollment ID: I20031110000677 |
| Provider Name | Althea T Conley |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1114995198 PECOS PAC ID: 7517851413 Enrollment ID: I20040819000963 |
| Provider Name | Rebecca A Luper |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1548245608 PECOS PAC ID: 6608841531 Enrollment ID: I20040901001374 |
| Provider Name | Benjamin M Dodge |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1922090471 PECOS PAC ID: 9436197175 Enrollment ID: I20050421001512 |
| Provider Name | Donald Voelker |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1548292386 PECOS PAC ID: 9931173879 Enrollment ID: I20060914000651 |
| Provider Name | Joseph A Deluca |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1417969478 PECOS PAC ID: 9335146844 Enrollment ID: I20061025000752 |
| Provider Name | Robert C Tommey |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1669467361 PECOS PAC ID: 4284730490 Enrollment ID: I20080716000469 |
| Provider Name | Teresa Mcdonald |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700058245 PECOS PAC ID: 9436343910 Enrollment ID: I20101028000704 |
| Provider Name | Julie N Wylie |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932377256 PECOS PAC ID: 1456546803 Enrollment ID: I20101110001208 |
| Provider Name | Angela Norman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174613962 PECOS PAC ID: 4587851381 Enrollment ID: I20101206000978 |
| Provider Name | Harvinder S Dod |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1699983635 PECOS PAC ID: 0042292047 Enrollment ID: I20110210000034 |
| Provider Name | Albert O Obiozo |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1932476132 PECOS PAC ID: 1254587249 Enrollment ID: I20120807000511 |
| Provider Name | Venkata Spb Durvasula |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1770861478 PECOS PAC ID: 2567608573 Enrollment ID: I20130418000006 |
| Provider Name | Chelsea R Mansfield |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669658837 PECOS PAC ID: 6901980796 Enrollment ID: I20140609001815 |
| Provider Name | Alero Nanna |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1588898761 PECOS PAC ID: 1254552409 Enrollment ID: I20141031001779 |
| Provider Name | Sharon M Tomaski |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1275605206 PECOS PAC ID: 3971586280 Enrollment ID: I20151022002017 |
| Provider Name | Anthony Milard Abraham |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1336474535 PECOS PAC ID: 1052563384 Enrollment ID: I20151210001785 |
| Provider Name | Oluwakunle Oluwatosin |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1396912796 PECOS PAC ID: 1557439262 Enrollment ID: I20151210002095 |
| Provider Name | Lensey C Scott |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1225126626 PECOS PAC ID: 7416082797 Enrollment ID: I20151223000334 |
| Provider Name | Edward Evans |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1083799985 PECOS PAC ID: 7012815046 Enrollment ID: I20151228000276 |
| Provider Name | Lashonda Evetta Traylor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306245345 PECOS PAC ID: 8426034331 Enrollment ID: I20160527000212 |
| Provider Name | Vivian Chioma Okoye |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1194067769 PECOS PAC ID: 9133415581 Enrollment ID: I20160910000159 |
| Provider Name | Stephanie M Dunn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578000287 PECOS PAC ID: 2062796170 Enrollment ID: I20170308001223 |
| Provider Name | Ashley Nicole Burns |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003355488 PECOS PAC ID: 2769768100 Enrollment ID: I20170419000786 |
| Provider Name | Peggy Wren |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225560162 PECOS PAC ID: 0446528517 Enrollment ID: I20170613002164 |
| Provider Name | Eliyahu Hemo |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1255627824 PECOS PAC ID: 7517277627 Enrollment ID: I20170819000026 |
| Provider Name | James Albert Johnson |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1053378257 PECOS PAC ID: 8325001662 Enrollment ID: I20180124000791 |
| Provider Name | Christopher John Riley |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1366785222 PECOS PAC ID: 3678866217 Enrollment ID: I20180927001604 |
| Provider Name | Gabriel T Faz |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1285936625 PECOS PAC ID: 1850682477 Enrollment ID: I20190408001869 |
| Provider Name | Umberto Gaetano Fontana |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1033111315 PECOS PAC ID: 0749326601 Enrollment ID: I20190729001088 |
| Provider Name | Jessica Daigle |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1922397413 PECOS PAC ID: 3375849003 Enrollment ID: I20190813003030 |
| Provider Name | Fahad Javed |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1033425087 PECOS PAC ID: 2668641317 Enrollment ID: I20191106001575 |
| Provider Name | Carlos Anaya |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1538120860 PECOS PAC ID: 1254474448 Enrollment ID: I20200203000253 |
| Provider Name | Irfan Qureshi |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1881853133 PECOS PAC ID: 5799006508 Enrollment ID: I20200623000221 |
| Provider Name | Abdul M Keylani |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1386692689 PECOS PAC ID: 5890755433 Enrollment ID: I20201016001514 |
| Provider Name | Samuel Agnew |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1952374498 PECOS PAC ID: 0547151318 Enrollment ID: I20210208000044 |
| Provider Name | Thomas Kennedy |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1396273173 PECOS PAC ID: 2567712904 Enrollment ID: I20220729000032 |
The Hannah Medical Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 101 W Main St, Suite 201, El Dorado, AR 71730 Phone: 870-862-1317 Fax: 870-862-4297 | |
Uams Health Primary Care Center - El Dorado Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 620 W Grove St Ste 202, El Dorado, AR 71730 Phone: 870-234-7676 Fax: 870-562-2560 | |
Cabun Rural Health Services, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 601 Dr. Mlk Jr. Blvd, El Dorado, AR 71730 Phone: 870-639-3875 Fax: 870-798-4100 | |
Remel Buslig Md Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 818 Doe Meadow Ln, El Dorado, AR 71730 Phone: 870-864-0913 Fax: 870-864-0913 | |
William L. Harper, M.d., P.a. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 425 W Oak St, El Dorado, AR 71730 Phone: 870-863-5135 Fax: 870-863-5137 | |
Greg Smart Family Practice Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 209 Thompson Ave, El Dorado, AR 71730 Phone: 870-864-0333 Fax: 870-864-0336 | |
South Arkansas Physician Group Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 620 W Grove St Ste 202, El Dorado, AR 71730 Phone: 870-863-2000 |