Lawrence County Family Clinic, PA
Organization Active NPI Family Medicine Physician · Walnut Ridge, AR
NPI 1942337282 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1942337282
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- LAWRENCE COUNTY FAMILY CLINIC, PA
- Practice address
- 1210 W Main St
Walnut Ridge, AR 72476-1005 - Phone
- (870) 886-3543
- Fax
- (870) 886-3252
- NPI assigned
- Feb 27, 2007
- Organization subpart
- No
Authorized official
- Name
- Ms. Karen Patterson
- Title
- Office Manager
- Phone
- (870) 886-3543
Other NPIs with the same Medicare PAC ID 1
Corporate family (same tax ID) 1
Practitioners 7
-
Charles D Davidson, M.D.
-
Cassandra Lou Hunter, M.D.
-
Shawn C Peyton, M.D.
-
Jeanne C Ross, MD
-
Sebastian A. Spades III, M.D.
-
Clay R Spencer, M.D.
-
Nancy J Baltz, APN
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AR
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040629000571 | AR | Part B Supplier - Clinic/Group Practice | 1557347572 |
Receives reassigned benefits from 7 practitioners Practice locations: Walnut Ridge, AR |
National Provider Directory
- Tax ID family
- Lawence County Family Clinic PA Rural Health Clinic
Locations
1210 W Main St
Walnut Ridge, AR 72476
Phone (870) 886-3543
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | Yes |
Addresses
Primary practice location
1210 W Main St
Walnut Ridge, AR 72476-1005
Mailing address
PO Box 719
Walnut Ridge, AR 72476-0719
Phone (870) 886-3543
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 56801 | Other | AR | BLUE CROSS BLUE SHIELD |
Other providers in Walnut Ridge, AR
- Kidspot Walnut Ridge2
- Meaghan Danielle Kingston
- Teddy S Lancaster
- Lawrence County Chiropractic Clinic, Inc.
- Lawrence County Family Clinic, PA
- Lawrence County School District
- Lawrence Hall Health & Rehabilitation
- Lawrence Health Services
- Lawrence Memorial Health Foundation Inc.
- Lawrence Memorial Health Foundation Inc.
All providers in Walnut Ridge, 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 Aug 22, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.