| S & R Clinic, Pa | |
|
1045 W Main Suite C Walnut Ridge AR 72476 | |
| (870) 886-8300 | |
| (870) 886-8302 |
| Full Name | S & R Clinic, Pa |
|---|---|
| Speciality | Clinic/Center |
| Location | 1045 W Main, Walnut Ridge, Arkansas |
| Authorized Official Name and Position | Roger Lee Troxel (PRESIDENT) |
| Authorized Official Contact | 8708868300 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| S & R Clinic, Pa Po Box 777 Walnut Ridge AR 72476-0777 Ph: (870) 886-8300 | S & R Clinic, Pa 1045 W Main Suite C Walnut Ridge AR 72476 Ph: (870) 886-8300 |
| NPI Number | 1356480818 |
|---|---|
| Provider Enumeration Date | 02/05/2007 |
| Last Update Date | 10/26/2009 |
| Medicare PECOS PAC ID | 0547436487 |
|---|---|
| Medicare Enrollment ID | O20111227000646 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356480818 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | C8313 (Arkansas) | Primary |
| Provider Name | Roger L Troxel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1669575569 PECOS PAC ID: 3375520711 Enrollment ID: I20111227000682 |
| Provider Name | Sandra L Troxel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003274275 PECOS PAC ID: 9133424278 Enrollment ID: I20160226001177 |
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