Dean W Papageorge, MD

Key facts

NPI

1942260146

Entity type

Individual (NPI type 1)

Primary specialty

Obstetrics & Gynecology Physician 207V00000X

License

E0482 (AR)

Practice address

105 Skyline Dr
Russellville, AR 72801-3363

Phone

(479) 968-2345

Fax

(479) 890-7101

NPI assigned

Mar 23, 2006

Sex

Male

Sole proprietor

No

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Advanced Aesthetics & Wellness Center PA, Earlmd Family Medicine PA Family Medicine Physician · Bentonville, AR · NPI 1811135809
  NPD (past)
• Family Medical Walk-in Clinic PA Urgent Care Clinic/Center · Rogers, AR · NPI 1376848978
  NPD (past)
• Northwest Benton County Physician Services LLC Family Medicine Physician · Bentonville, AR · NPI 1871553073
  NPD (past)
• St Marys Physician Services, LLC Interventional Cardiology Physician · Russellville, AR · NPI 1720356207
  NPD (past)

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 Medicine

State licenses

Practice roles

Specialties & licenses

Addresses

Other identifiers

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jan 29, 2009.

{
    "created_epoch": "1143072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1233187200000",
    "number": "1942260146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 SKYLINE DR",
            "city": "RUSSELLVILLE",
            "state": "AR",
            "postal_code": "728013363",
            "telephone_number": "479-968-2345",
            "fax_number": "479-890-7101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 SKYLINE DR",
            "city": "RUSSELLVILLE",
            "state": "AR",
            "postal_code": "728013363",
            "telephone_number": "479-968-2345",
            "fax_number": "479-890-7101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAPAGEORGE",
        "first_name": "DEAN",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-23",
        "last_updated": "2009-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "AR",
            "license": "E0482",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "127100001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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All providers in Russellville, AR · Obstetrics & Gynecology Physician in Arkansas