PATHOLOGY SERVICES LABORATORY PA (NPI# 1093889347) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093889347 |
| Entity Type | Organization |
| Organization Name | PATHOLOGY SERVICES LABORATORY PA |
| Practice Address |
1430 West C Street Russellville AR 72811-0925 |
| Mailing Address |
Po Box 925 Russellville AR 72811-0925 |
| Practice Telephone | 4799686781 |
| Practice Fax Number | 4799683074 |
| Mailing Telephone | 4799686781 |
| Mailing Fax Number | 4799683074 |
| Enumeration Date | 2006-11-20 |
| Last Update Date | 2016-11-07 |
| Authorized Official Name | MRS. CHRISTINA ANN JETTON (PRESIDENT) |
| Authorized Official Telephone | 4799686781 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207ZP0102X |
Pathology Specialization: Anatomic Pathology & Clinical Pathology |
MC0330 | AR | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AR | 103882709 | 05 | |
| BREASTCARE | 770091902 | 01 | |
| AR | LICENSE NUMBER | MC0330 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831158369 | Pathology Services Laboratory Pa | Pathology | 1430 West C Street, Russellville, AR 72801 | 2006-03-22 |
| Street Address |
1430 WEST C STREET |
| City | RUSSELLVILLE |
| State | AR |
| Zip Code | 72811-0925 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831158369 | Pathology Services Laboratory Pa | Pathology | 1430 West C Street, Russellville, AR 72801 | 2006-03-22 |
| 1467417121 | Gerald A Stolz Jr. | Pathology | 1430 West C Street, Russellville, AR 72801 | 2006-04-18 |
| 1780646620 | Laura Marie Lowther | Pathology | 1430 West C Street, Russellville, AR 72801 | 2006-04-05 |
| 1538121637 | Sybil R Hart | Pathology | 1430 West C Street, Russellville, AR 77801 | 2006-04-04 |
| 1396706172 | Vernon Anthony Harden | Pathology | 1430 West C Street, Russellville, AR 72801 | 2006-03-31 |
| 1336109388 | Craig A Ferris | Pathology | 1430 West C Street, Russellville, AR 72801 | 2006-03-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134447246 | Cn Anesthesia Inc | Nurse Anesthetist, Certified Registered | 151 East Aspen Lane, Russellville, AR 72811 | 2010-05-13 |
| 1093830382 | Brenda Holmes | Physical Therapy Assistant | 1301 Russell Road, Russellville, AR 72811 | 2007-03-19 |
| 1235149469 | Pope County Imaging | Clinic/Center | 3127 W 2nd Court, Ste A, Russellville, AR 72811 | 2006-08-09 |
| 1154350213 | Monfee Medical Clinic | Family Medicine | 3812 W. Main St., Russellville, AR 72811 | 2006-07-01 |
| 1902921901 | Libby Tipton | Speech-Language Pathologist | 1301 Russell Road, Russellville, AR 72811 | 2007-03-20 |
| Taxonomy Code | 207ZP0102X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pathology |
| Specialization | Anatomic Pathology & Clinical Pathology |
| A pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the laboratory application of the biologic, chemical and physical sciences. A pathologist uses information gathered from the microscopic examination of tissue specimens, cells and body fluids, and from clinical laboratory tests on body fluids and secretions for the diagnosis, exclusion and monitoring of disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added, 7/1/2009: definition reformatted] Additional Resources: American Board of Pathology, 2007. http://www.abpath.org/ This taxonomy code identifies the combined anatomic pathology & clinical pathology route. Board certification for Medical Doctors (MDs) is provided by the American Board of Pathology. To acknowledge the diverse activities in the practice of pathology and to accommodate the interests of individuals wanting to enter the field, the ABP offers primary certification through the following three routes: combined anatomic pathology and clinical pathology, anatomic pathology only and clinical pathology only. Primary certification in anatomic pathology or clinical pathology may be combined with some of the subspecialty certifications. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912969858 | Jorge F Jimenez | Pathology | 1430 West C, Russellville, AR 72801 | 2006-04-05 |
| 1205895745 | Christina A Jetton | Pathology | 1430 W C St, Russellville, AR 72801-2805 | 2006-03-22 |
| 1831158369 | Pathology Services Laboratory Pa | Pathology | 1430 West C Street, Russellville, AR 72801 | 2006-03-22 |
| 1467417121 | Gerald A Stolz Jr. | Pathology | 1430 West C Street, Russellville, AR 72801 | 2006-04-18 |
| 1780646620 | Laura Marie Lowther | Pathology | 1430 West C Street, Russellville, AR 72801 | 2006-04-05 |
| 1538121637 | Sybil R Hart | Pathology | 1430 West C Street, Russellville, AR 77801 | 2006-04-04 |
| 1396706172 | Vernon Anthony Harden | Pathology | 1430 West C Street, Russellville, AR 72801 | 2006-03-31 |
| 1336109388 | Craig A Ferris | Pathology | 1430 West C Street, Russellville, AR 72801 | 2006-03-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245640564 | Aaron Wyble | Pathology | 4301 W Markham St # 503, Little Rock, AR 72205 | 2014-05-08 |
| 1336486430 | William Edward Atkinson Jr. | Pathology | 22 Old Delmonte Drive, Little Rock, AR 72212 | 2013-01-09 |
| 1427303437 | Dalal Farid Jacob | Pathology | 1224 Cherokee Dr, Newport, AR 72112-9998 | 2012-07-16 |
| 1871870782 | Alex Pappas | Pathology | 1624 Mountain Dr, Little Rock, AR 72227-5837 | 2011-11-05 |
| 1740575810 | John Mcconnell | Pathology | 7220 West Ridge Rd., Roland, AR 72135-9595 | 2011-06-16 |
| 1295025492 | Melody Harrison | Pathology | 1 Lile Ct Ste 101, Little Rock, AR 72205-6239 | 2011-04-10 |
| 1710126529 | Johnnie Mack Boyce | Pathology | 104 Harris Lane, Springdale, AR 72764-2530 | 2009-02-18 |
| 1679719017 | Ericka J Olgaard | Pathology | 4301 W. Markham Street, Slot 502, Little Rock, AR 72205 | 2009-01-06 |
| 1285888446 | Dalton Eugene Packmore | Pathology | 3005 Riverbend Rd, Heber Springs, AR 72543-8616 | 2008-11-13 |
| 1144431883 | Adam J Cole | Pathology | 25 Valley Estates Dr, Little Rock, AR 72212-4412 | 2007-05-24 |
| Find all providers with the same taxonomy | ||||
| City | RUSSELLVILLE |
| Zip Code | 72811 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.