Monticello Ess LLC

Organization Active NPI Emergency Medicine Physician · Monticello, AR

NPI 1184010753 · NPPES record last updated Oct 2, 2019

Key facts

NPI
1184010753
Entity type
Organization (NPI type 2)
Primary specialty
Emergency Medicine Physician 207P00000X
Legal business name
MONTICELLO ESS LLC
Practice address
778 Scogin Dr
Monticello, AR 71655-5729
Phone
(870) 367-2411
NPI assigned
Apr 10, 2015
Organization subpart
No

Authorized official

Name
Mr. Ron Weiss
Title
Ceo
Phone
(866) 931-8882

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Practitioners 123

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 123

Medicare participation

Medicare fee-for-service enrollment
Enrolled in AR

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20150519002625 AR Part B Supplier - Clinic/Group Practice 4880914639 Receives reassigned benefits from 123 practitioners
Practice locations: Monticello, AR

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207P00000X Yes

Addresses

Primary practice location

778 Scogin Dr
Monticello, AR 71655-5729

Mailing address

17304 Preston Rd
Suite 1400
Dallas, TX 75252-5618
Phone (866) 931-8882

Other providers in Monticello, AR

All providers in Monticello, AR · Emergency Medicine Physician in Arkansas

Sources for this page

Verify at the official NPI Registry.