DR. GREGORY S. BACKOFEN (NPI# 1619231966) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619231966 |
| Entity Type | Individual |
| Full Name | DR. GREGORY S. BACKOFEN |
| Credential | M.D. |
| Practice Address |
460 W Oak St El Dorado AR 71730-4567 |
| Mailing Address |
2421 Worth St Hemphill TX 75948-7215 |
| Practice Telephone | 8708814463 |
| Mailing Telephone | 4097871416 |
| Enumeration Date | 2012-07-02 |
| Last Update Date | 2015-09-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208D00000X | General Practice | E-9281 | AR | Allopathic & Osteopathic Physicians |
| Y | 208D00000X | General Practice | Q5755 | TX | Allopathic & Osteopathic Physicians |
| Street Address |
460 W OAK ST |
| City | EL DORADO |
| State | AR |
| Zip Code | 71730-4567 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659365351 | Michael Fitts | Psychologist | 460 W Oak St, El Dorado, AR 71730-4500 | 2005-09-08 |
| 1144584392 | Erwin R Espino | Family Medicine | 460 W Oak St, El Dorado, AR 71730-4567 | 2012-07-02 |
| 1437300860 | Eli Vinson | Pharmacist | 460 W Oak St, El Dorado, AR 71730-4567 | 2008-10-03 |
| 1902005234 | Michael Beltran Corpus | Family Medicine | 460 W Oak St, El Dorado, AR 71730-4567 | 2007-07-17 |
| 1326257387 | Shu Zhang | Family Medicine | 460 W Oak St, El Dorado, AR 71730-4567 | 2007-05-22 |
| 1427018704 | South Arkansas Physician Services LLC | Family Medicine | 460 W Oak St, Suite 601, El Dorado, AR 71730-4567 | 2006-03-23 |
| 1164419776 | Kimberly Ann Havard | Nurse Practitioner | 460 W Oak St, El Dorado, AR 71730-4500 | 2005-09-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043856172 | Mental Health Counseling for Individuals and Couples | Clinic/Center | 3256 West Hillsboro Suite C, El Dorado, AR 71730 | 2019-11-25 |
| 1114578168 | Candance Marie Guinn | Nurse Practitioner | 1906 W Hillsboro St Ste B, El Dorado, AR 71730 | 2019-09-20 |
| 1811460462 | Kelsie Rogers | Pharmacist | 2202 N West Ave, El Dorado, El Dorado, AR 71730 | 2019-01-07 |
| 1861925331 | Kasey Leigh Mcclain | Nurse Practitioner | 2280 E Main St, El Dorado, AR 71730 | 2017-04-11 |
| 1366989568 | Shane Morr | Marriage & Family Therapist | 704 W 5th Dr, El Dorado, AR 71730 | 2017-01-25 |
| 1376986539 | Ivory A. Kinslow, Mdpa | Optometrist | 443 W Oak St, El Dorado, AR 71730 | 2013-04-08 |
| 1134485170 | Drs Weddle and Baumsardner | Dentist | 106 West Main St. 212, El Dorado, AR 71730 | 2012-04-04 |
| 1972888923 | Lenora S Newsome | Pharmacist | 2135 North West Ave, El Dorado, AR 71730 | 2011-10-20 |
| 1730460338 | South Arkansas Pharmacy, Inc | Pharmacy | 600 South Timberlane #101, El Dorado, AR 71730 | 2011-09-09 |
| 1710273891 | Ezinne Charity Nwude | Emergency Medicine | 701 N. West Avenue, El Dorado, AR 71730 | 2011-06-27 |
| Find all providers in zip 71730 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053706655 | Aubrey Shea Ralston | General Practice | 700 W Central Ave Ste 205, El Dorado, KS 67042 | 2015-03-31 |
| 1992079917 | Kenneth C. Prather, M.d., P.a. | General Practice | 460 W Oak, El Dorado, AR 71730-8525 | 2012-03-08 |
| 1578546131 | James E Seale Jr. | General Practice | 701 W Oak St, El Dorado, AR 71730-5487 | 2005-11-28 |
| 1013439926 | Susan B. Allen Memorial Hospital | General Practice | 720 W Central Ave, El Dorado, KS 67042-2112 | 2017-07-12 |
| 1255771598 | Greg Smart Family Practice | General Practice | 209 Thompson Ave, El Dorado, AR 71730-5755 | 2013-07-01 |
| 1164554820 | Susan B. Allen Memorial Hospital | General Practice | 720 W Central Ave, El Dorado, KS 67042-2112 | 2007-03-09 |
| 1821023292 | South Arkansas Physician Services, LLC | General Practice | 714 W Faulkner St, El Dorado, AR 71730-4598 | 2006-07-12 |
| 1023086931 | Kenneth C Prather | General Practice | 700 W Grove St, El Dorado, AR 71730-4416 | 2006-03-08 |
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| 1215586797 | Achor Management Inc | General Practice | 1900 Club Manor Dr Ste 101a, Maumelle, AR 72113-7443 | 2019-09-08 |
| 1093364820 | Center for Regenerative Medicine Pa | General Practice | 9307 Maumelle Blvd, North Little Rock, AR 72113-6609 | 2019-09-04 |
| 1083269690 | University of Arkansas At Monticello | General Practice | 663 University Drive, Monticello, AR 71656 | 2019-08-09 |
| 1912492786 | Chelsea Brown | General Practice | 6309 Highway 5 N, Bryant, AR 72022-8506 | 2018-06-25 |
| 1205345154 | Lakeside Walk-in Clinic Pllc | General Practice | 2230 Malvern Ave Ste E, Hot Springs, AR 71901-8000 | 2017-09-22 |
| 1558897595 | Epoch-nwa Pllc | General Practice | 5100 W Pauline Whitaker Pkwy, Ste. 110, Rogers, AR 72758-8335 | 2017-05-11 |
| 1023540655 | Aaron M Smith | General Practice | Varner Unit State Hwy 388, Gould, AR 71643 | 2017-04-02 |
| 1942749148 | Reece Lewis Crow | General Practice | 34 Windsor Road, Little Rock, AR 72212 | 2017-02-21 |
| Find all providers with the same taxonomy | ||||
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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.