Southern Medical Associates, PLLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

E1629 Issued in AR

Legal business name

SOUTHERN MEDICAL ASSOCIATES, PLLC

Practice address

6810 S Hazel St
Pine Bluff, AR 71603-7828

Phone

(870) 541-0342

Fax

(870) 850-2946

NPI assigned

Aug 5, 2010

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Anthony K Gordon, MD

Title

President/Physician

Phone

87071816128506053

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1280966400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1393200000000",
    "number": "1578877205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 NOYANT DR",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722235078",
            "telephone_number": "870-541-0342",
            "fax_number": "870-850-2946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6810 S HAZEL ST",
            "city": "PINE BLUFF",
            "state": "AR",
            "postal_code": "716037828",
            "telephone_number": "870-541-0342",
            "fax_number": "870-850-2946"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN MEDICAL ASSOCIATES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-05",
        "last_updated": "2014-02-24",
        "status": "A",
        "authorized_official_last_name": "GORDON",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PRESIDENT/PHYSICIAN",
        "authorized_official_telephone_number": "87071816128506053",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "E1629",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "184916002",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Southeast Arkansas Hospitalists, LLP
• Southeast Arkansas Oncology, PA
• Southeast Arkansas Physical Therapy, Inc.
• Southeast Arkansas Preparatory High School
• Southeast Arkansas Primary Care Associates
• Anja Spadoni, MHPP
• Kimberly M Spivey, P.T.
• Austin Gage Stanage, PHARMD
• State of Arkansas
• Charles J Stearns, MD

• Family Medicine Physician in Pine Bluff, AR
• Providers in Pine Bluff, AR by specialty
• Family Medicine Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.