Oak Park Medical C,Linic, P.a.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

C-4126 Issued in AR

Legal business name

OAK PARK MEDICAL C,LINIC, P.A.

Practice address

1301 White Dr
Batesville, AR 72501-9467

Phone

(870) 793-6887

Fax

(870) 793-8085

NPI assigned

Mar 21, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Lackey Gene Moody, M.D.NPI 1730149741

Title

Ceo

Phone

(870) 793-9887

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Lackey Gene Moody, M.D.

  • Family Medicine Physician
  • Batesville, AR
  • NPI 1730149741
  Authorized official Same address or phone
• Mary S Anderson, MD

  • Family Medicine Physician
  • Marshall, TX
  • NPI 1083611057
  NPD (past)
• Richard Thomas Oliver Jr., PA-C

  • Medical Physician Assistant
  • Spokane, WA
  • NPI 1699000224
  NPD (past)

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

{
    "created_epoch": "1142899200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1902865579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2335",
            "city": "BATESVILLE",
            "state": "AR",
            "postal_code": "725032335",
            "telephone_number": "870-793-6887",
            "fax_number": "870-793-8085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 WHITE DR",
            "city": "BATESVILLE",
            "state": "AR",
            "postal_code": "725019467",
            "telephone_number": "870-793-6887",
            "fax_number": "870-793-8085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OAK PARK MEDICAL C,LINIC, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MOODY",
        "authorized_official_first_name": "LACKEY",
        "authorized_official_middle_name": "GENE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "870-793-9887",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "C-4126",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "57250",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• North Arkansas Pain Managment PA
• North Arkansas Radiology
• Northeast Arkansas Community Mental Health Center Inc Inc (Mid South Health Systems)
• Morgan E. Norton, M.D.
• Amy Leigh O'Rourke
• Nelson A. Obikwu, MD
• Occuplaytional Therapy Services
• Odyssey Healthcare Operating a, LP (Gentiva)
• Lisa Ohlson, LMSW
• Samson Olaitan, MD

• Family Medicine Physician in Batesville, AR
• Providers in Batesville, 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 Aug 22, 2020; 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.