PRIME MEDICAL GROUP PLLC (NPI# 1790384899) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790384899 |
| Entity Type | Organization |
| Organization Name | PRIME MEDICAL GROUP PLLC |
| Practice Address |
353 Cash Rd Sw Camden AR 71701-3704 |
| Mailing Address |
9601 Baptist Health Dr Ste 690 Little Rock AR 72205-6328 |
| Practice Telephone | 5012278422 |
| Practice Fax Number | 5015372399 |
| Mailing Telephone | 5012278422 |
| Mailing Fax Number | 5015372399 |
| Enumeration Date | 2020-10-20 |
| Last Update Date | 2020-10-20 |
| Authorized Official Name | RAY KOHLER PARKER (PHYSICIAN) |
| Authorized Official Telephone | 5012278422 |
| Is Organization Subpart | Y |
| Parent Organization Name | PRIME MEDICAL GROUP PLLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AR | 239906002 | 05 |
| Other Name | Type Code |
|---|---|
| Dermatology Group of Arkansas PA | Doing Business As Name - Organization |
| Dermatology Group of Arkansas, PA | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629677737 | Prime Medical Group Pllc | Dermatology | 1416 W 43rd Ave, Pine Bluff, AR 71603-7010 | 2020-10-20 |
| 1790384808 | Prime Medical Group Pllc | Dermatology | 625 United Dr Ste 320, Conway, AR 72032-7828 | 2020-10-20 |
| 1649879750 | Prime Medical Group Pllc | Dermatology | 5 Medical Park Dr Ste 200, Benton, AR 72015-3732 | 2020-10-20 |
| 1528667672 | Prime Medical Group Pllc | Dermatology | 315 Section Line Rd Ste A&b, Hot Springs, AR 71913-6480 | 2020-10-20 |
| 1942809058 | Prime Medical Group Pllc | Dermatology | 16115 Saint Vincent Way Ste 300, Little Rock, AR 72223-3000 | 2020-10-20 |
| 1427605153 | Prime Medical Group Pllc | Dermatology | 9601 Baptist Health Dr Ste 690, Little Rock, AR 72205-6328 | 2019-08-19 |
| Street Address |
353 CASH RD SW |
| City | CAMDEN |
| State | AR |
| Zip Code | 71701-3704 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730173600 | Morrisons Properties Inc | Pharmacy | 353 Cash Rd Sw, Camden, AR 71701-3704 | 2005-09-07 |
| 1699382440 | David Allen Davidson | Physician Assistant | 353 Cash Rd Sw, Camden, AR 71701-3704 | 2020-09-25 |
| 1750846739 | Brittany Coleman | Nurse Practitioner | 353 Cash Rd Sw, Camden, AR 71701-3704 | 2019-02-05 |
| 1598238446 | Lab One LLC | Clinical Medical Laboratory | 353 Cash Rd Sw, Camden, AR 71701-3704 | 2019-01-03 |
| 1457797839 | Jerakaycia Smith | Family Medicine | 353 Cash Rd Sw, Camden, AR 71701-3704 | 2013-05-13 |
| 1578599957 | Perkins & Arnold, Pllc | Surgery | 353 Cash Rd Sw, Camden, AR 71701-3704 | 2006-06-25 |
| 1972564003 | Kimyon L Mccord | Physician Assistant | 353 Cash Rd Sw, Camden, AR 71701-3704 | 2006-03-29 |
| 1750342804 | William D Dedman | Family Medicine | 353 Cash Rd Sw, Camden, AR 71701-3704 | 2006-03-29 |
| 1578530366 | Mark R Crump | Family Medicine | 353 Cash Rd Sw, Camden, AR 71701-3704 | 2006-03-01 |
| 1447227244 | Milton E Brunson | Obstetrics & Gynecology | 353 Cash Rd Sw, Camden, AR 71701-3704 | 2006-03-01 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104456854 | Teresa Mccann | Pharmacist | Brookshire's Pharmacy #85, 1345 Hwy 4 Spur Sw, Camden, AR 71701 | 2020-01-22 |
| 1366938870 | American Oncology Partners, P.a. | Internal Medicine | 115 Fairview Rd Sw, Camden, AR 71701 | 2018-07-09 |
| 1609236454 | Laquisha Kelley | Case Manager/Care Coordinator | 211 South Jackson Street, Camden, AR 71701 | 2016-03-07 |
| 1649654435 | Gerald Stinnett | Occupational Therapy Assistant | 431 Ouachita 51, Camden, AR 71701 | 2015-07-13 |
| 1902105232 | Joannie Phelps | Counselor | 301a Washington, Camden, AR 71701 | 2011-03-25 |
| 1053540732 | Judy Prince | Counselor | 115 Jefferson Sw, Camden, AR 71701 | 2009-07-02 |
| 1861641532 | Candace Bowen | Occupational Therapy Assistant | 1320 Maul North West Road, Camden, AR 71701 | 2008-09-17 |
| 1073739587 | Harmony Grove School District | Local Education Agency (LEA) | 401 Oua Rd 88, Camden, AR 71701 | 2007-04-17 |
| 1215055876 | Angela Mashel Rich | Counselor | 1269 California Sw, Camden, AR 71701 | 2007-03-26 |
| 1104954791 | Lisa H Stevens | Speech-Language Pathologist | 400 Maul Road, Camden, AR 71701 | 2007-03-02 |
| Find all providers in zip 71701 | ||||
| Taxonomy Code | 207N00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124667191 | Morris S Minton Md Faad Pa | Dermatology | 87 Elm St Ste 104a, Camden, ME 04843-1963 | 2019-12-23 |
| 1851338057 | Csc Acquisition, LLC | Dermatology | 1205 Lyttleton St, Camden, SC 29020-3615 | 2006-05-31 |
| 1851378194 | Lee T Jordan | Dermatology | 1102 Roberts Street, Camden, SC 29020 | 2005-12-28 |
| 1447552948 | Sandra Anne Kopp | Dermatology | 3 Cooper Plz, Suite 215, Camden, NJ 08103-1438 | 2010-12-03 |
| 1497946107 | Cmc Department of Medicine | Dermatology | 3 Cooper Plz, Suite 215, Camden, NJ 08103-1438 | 2007-08-07 |
| 1962454504 | The Dermatology Group LLC | Dermatology | 1102 Roberts Street, Camden, SC 29020-4525 | 2006-05-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629677737 | Prime Medical Group Pllc | Dermatology | 1416 W 43rd Ave, Pine Bluff, AR 71603-7010 | 2020-10-20 |
| 1790384808 | Prime Medical Group Pllc | Dermatology | 625 United Dr Ste 320, Conway, AR 72032-7828 | 2020-10-20 |
| 1649879750 | Prime Medical Group Pllc | Dermatology | 5 Medical Park Dr Ste 200, Benton, AR 72015-3732 | 2020-10-20 |
| 1528667672 | Prime Medical Group Pllc | Dermatology | 315 Section Line Rd Ste A&b, Hot Springs, AR 71913-6480 | 2020-10-20 |
| 1487064473 | Laura Raquel Battle | Dermatology | 500 South 52nd Street, Rogers, AR 72758-7275 | 2014-04-30 |
| 1174942528 | Jacey Tanner Guthrie | Dermatology | 4200 N Rodney Parham Rd Ste 202, Little Rock, AR 72212 | 2014-04-14 |
| 1801215751 | Allison Noel Hood | Dermatology | 9601 Baptist Health Drive Suite 860, Little Rock, AR 72205 | 2014-04-08 |
| 1710229141 | Mallory Hurst | Dermatology | 800 S Church St Ste 202, Jonesboro, AR 72401 | 2013-03-24 |
| 1720333990 | Vivian Shi | Dermatology | 4018 W Capitol Ave, Little Rock, AR 72205 | 2012-07-13 |
| 1295098440 | Garrett James Nelson | Dermatology | 9601 Baptist Health Dr Ste 690, Little Rock, AR 72205-6328 | 2012-06-22 |
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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.