| Family Medical Center in Pine Bluff | |
|
1601 W 40th Ave Pine Bluff AR 71603-6069 | |
| (870) 541-6000 | |
| (870) 541-3198 |
| Full Name | Family Medical Center in Pine Bluff |
|---|---|
| Speciality | Family Medicine |
| Location | 1601 W 40th Ave, Pine Bluff, Arkansas |
| Authorized Official Name and Position | Amanda George (VICE CHANCELLOR-CHIEF FINANCIAL OFF) |
| Authorized Official Contact | 5016865670 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Medical Center in Pine Bluff Po Box 251420 Little Rock AR 72225-1420 Ph: (501) 686-8000 | Family Medical Center in Pine Bluff 1601 W 40th Ave Pine Bluff AR 71603-6069 Ph: (870) 541-6000 |
| NPI Number | 1831144120 |
|---|---|
| Provider Enumeration Date | 05/24/2006 |
| Last Update Date | 06/19/2025 |
| Certification Date | 06/19/2025 |
| Medicare PECOS PAC ID | 4082528955 |
|---|---|
| Medicare Enrollment ID | O20040709000013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831144120 | NPI | - | NPPES |
| 303764002 | Medicaid | AR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | () | Primary |
| 261QC1500X | Clinic/center - Community Health | () | Secondary |
| Provider Name | Toni Middleton |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1093750671 PECOS PAC ID: 4587646781 Enrollment ID: I20040602000828 |
| Provider Name | Steven Wright |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1598771677 PECOS PAC ID: 2769392810 Enrollment ID: I20080626000360 |
| Provider Name | Herbert Farrell Fendley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1568499986 PECOS PAC ID: 8820153729 Enrollment ID: I20090209000670 |
| Provider Name | Harvie Marks Attwood |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1568407088 PECOS PAC ID: 8628112471 Enrollment ID: I20100218000113 |
| Provider Name | Darrell R Over |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700842218 PECOS PAC ID: 4789691759 Enrollment ID: I20100713000363 |
| Provider Name | Richard Justiss |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1982631313 PECOS PAC ID: 6002726726 Enrollment ID: I20100715000902 |
| Provider Name | Jason B Cobb |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1215164629 PECOS PAC ID: 1052531209 Enrollment ID: I20141010000158 |
| Provider Name | Katrena L Gordon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952769614 PECOS PAC ID: 2769788165 Enrollment ID: I20160310002238 |
| Provider Name | Nathan Probst |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1508213984 PECOS PAC ID: 8527333251 Enrollment ID: I20171006000074 |
| Provider Name | Rayna B Penister |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1619354818 PECOS PAC ID: 4981917101 Enrollment ID: I20181130002218 |
| Provider Name | Nasir Khan |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1285061226 PECOS PAC ID: 4385939974 Enrollment ID: I20191101001906 |
| Provider Name | Elizabeth Eoff |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1851827679 PECOS PAC ID: 9739454489 Enrollment ID: I20191105001508 |
| Provider Name | Raj Patel |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1366888711 PECOS PAC ID: 2769734813 Enrollment ID: I20200817002914 |
| Provider Name | Pavana Tirumanisetti |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1083920086 PECOS PAC ID: 5395975213 Enrollment ID: I20200928002555 |
| Provider Name | Primus I Mbawuike |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487008793 PECOS PAC ID: 4082083118 Enrollment ID: I20221213001934 |
| Provider Name | Appala S Peela |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1336671320 PECOS PAC ID: 9638456528 Enrollment ID: I20240725004425 |
| Provider Name | Hamilton C Newhart |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1811575012 PECOS PAC ID: 0749699726 Enrollment ID: I20250617002419 |
| Provider Name | Adrianne F Basa |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1538713623 PECOS PAC ID: 3779095716 Enrollment ID: I20250625000759 |
Arcare140 Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2500 Rike Dr, Pine Bluff, AR 71603 Phone: 870-347-3475 |
John E Harris MD PA Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1801 W 40th Ave, Suite 5c, Pine Bluff, AR 71603 Phone: 870-534-0202 Fax: 870-534-8836 |
Primary Care of Pine Bluff Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1400 Claud Rd, Pine Bluff, AR 71602 Phone: 870-247-9499 |
Jccsi Cross Over Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1101 Tennssee, Pine Bluff, AR 71601 Phone: 870-543-2380 Fax: 870-535-4716 |
Mike S. Mcfarland Mdpa Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 3805 W 28th Ave, Pine Bluff, AR 71603 Phone: 870-536-4100 Fax: 870-534-3982 |
Cdu, PLLC Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1600 W 42nd Ave, Pine Bluff, AR 71603 Phone: 870-541-7111 Fax: 870-850-6482 |