Unknown Individual – Physician Assistant, NPI 1295065068
Physician Assistant
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Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Unknown Individual
Malvern Post Office, Martin Luther King Boulevard, Malvern, Hot Spring County, Arkansas, 72104, United States
MALVERN, PA 193550746
Phone: (580) 749-4729
Fax: (580) 749-4721
Type: Mailing
North 4th Street, Ponca City, Kay County, Oklahoma, 74601, United States
PONCA CITY, OK 746012749
Phone: (580) 749-4729
Fax: (580) 749-4721
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
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Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
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No Medicare enrollment or revalidation data available for this provider in our database.
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Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 19355)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | AZ | |
| - | AZ | |
| - | TN | |
| - | AZ | |
| - | AZ |
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