Beavers, Homer Kevin
Beavers, Homer Kevin is an individual health care provider with primary practice located at 101 Skyline Dr , Russellville AR 72801. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Beavers, Homer Kevin can be contacted via phone (479) 968-2345.Contact Information
Primary practice address
101 Skyline Dr
Russellville AR 72801
Phone: (479) 968-2345
Fax: (479) 890-7194
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | C-6569 | Arkansas |
Profile Details
| NPI number | 1982660742 |
|---|---|
| LBN Legal business name | Beavers, Homer Kevin |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 21st, 2006 |
| Last updated | May 16th, 2018 - about 8 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1982660742 | NPPES |
| Arkansas | MEDICAID | 113402001 |
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