Prime Medical Group Pllc

LBN: Prime Medical Group Pllc
Prime Medical Group Pllc is an health care organization with primary practice located at 1416 W 43Rd Ave , Pine Bluff AR 71603-7010. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as the primary health care specialty. Prime Medical Group Pllc can be contacted via phone (870) 535-7477, or through Parker, Ray Kohler via phone (501) 227-8422.

Contact Information

Primary practice address
1416 W 43Rd Ave Pine Bluff AR 71603-7010
Phone: (870) 535-7477
Fax: (870) 535-4121
Website:
Map and Directions
Authorized official contact:
Name: Parker, Ray Kohler
Phone: (501) 227-8422

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatology 207N00000X

Profile Details

NPI number 1629677737
LBN Legal business name Prime Medical Group Pllc
DBA Doing business as
Authorized official Parker, Ray Kohler
Entity Organization
Organization subpart 1 Yes
Enumeration date Oct 20th, 2020
Last updated Oct 20th, 2020 - about 6 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1629677737 NPPES
Arkansas MEDICAID 2399040002

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