John C Urban, D.O.
Individual provider Active NPI Family Medicine Physician · Ratcliff, AR
NPI 1124195698 · NPPES record last updated Dec 14, 2011
Key facts
- NPI
- 1124195698
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- E-6881 (AR)
- Practice address
- 9755 W State Highway 22
Ratcliff, AR 72951-9000 - Phone
- (479) 635-5300
- Fax
- (479) 635-2010
- NPI assigned
- Nov 29, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 4
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| McLaren Medical Group | Family Medicine | Past | Accepting new patients |
| Booneville Community Hospital, Inc | Past | Accepting new patients | |
| Booneville Community Hospital, Inc. | Past | Accepting new patients | |
| McLaren Primary Care | Family Medicine | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 5101013179 | MI | |
| Family Medicine Physician | 207Q00000X | E-6881 | AR | Yes |
Addresses
Primary practice location
9755 W State Highway 22
Ratcliff, AR 72951-9000
Mailing address
PO Box 130
Ratcliff, AR 72951-0130
Phone (479) 635-5300
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4794578 | Medicaid | MI | |
| 186063003 | Medicaid | AR |
Other providers in Ratcliff, AR
- River Valley Primary Care Services Inc
- Peggy Rosson
- Sheridan Schneider
- Sam R. Shanlever
- Theodora L Short
- Edward A Vela
All providers in Ratcliff, AR · Family Medicine Physician in Arkansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 14, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.