Samuel Vallery (NPI# 1033110556, PAC ID# 5294719290) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is OTOLARYNGOLOGY.
| Nation Provider ID (NPI) | 1033110556 |
| PAC ID by PECOS | 5294719290 |
| Professional Enrollment ID | I20040616001346 |
| Full Name | Samuel Vallery |
| Organization Legal Name | SOUTH ARKANSAS PHYSICIAN SERVICES LLC |
| Address |
620 W Grove St El Dorado AR 71730-4425 |
| Gender | M |
| Credential | MD |
| Medical School | UNIVERSITY OF MISSOURI, COLUMBIA SCHOOL OF MEDICINE |
| Graduation Year | 1990 |
| Primary Specialty | OTOLARYNGOLOGY |
| Group Practice PAC ID | 0749273670 |
| Number of Group Practice Members | 8 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 040088 | MEDICAL CENTER OF SOUTH ARKANSAS |
| Address | Phone | Organization |
|---|---|---|
| 620 W Grove St, El Dorado, AR 71730-4425 | SOUTH ARKANSAS PHYSICIAN SERVICES LLC |
| Organization Legal Name | SOUTH ARKANSAS PHYSICIAN SERVICES LLC |
| Physicians | 12 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Tiffany Dawn Lucas | Nurse Practitioner | South Arkansas Physician Services LLC | 815 Thompson Ave, El Dorado, AR 71730-4464 |
| Pamela J Schonefeld | Internal Medicine | South Arkansas Physician Services LLC | 700 W Grove St, El Dorado, AR 71730-4416 |
| Anthony M Abraham | General Surgery | South Arkansas Physician Services LLC | 700 W Grove St, El Dorado, AR 71730-4416 |
| Mark Rothwell Gibbs | General Surgery | South Arkansas Physician Services LLC | 700 W Grove St, El Dorado, AR 71730-4416 |
| Robert C Tommey | General Surgery | South Arkansas Physician Services LLC | 700 W Grove St, El Dorado, AR 71730-4416 |
| Martha G Garrett Shaver | Family Medicine | South Arkansas Physician Services LLC | 620 W Grove St, El Dorado, AR 71730-4425 |
| Nicky L Pipkin | Thoracic Surgery | South Arkansas Physician Services LLC | 700 W Grove St, El Dorado, AR 71730-4416 |
| Teresa Mcdonald | Nurse Practitioner | South Arkansas Physician Services LLC | 700 W Grove St, El Dorado, AR 71730-4416 |
| Ashley Burns | Nurse Practitioner | South Arkansas Physician Services LLC | 700 W Grove St, El Dorado, AR 71730-4416 |
| Angela Norman | Nurse Practitioner | South Arkansas Physician Services LLC | 815 Thompson Ave, El Dorado, AR 71730-4464 |
| Street Address |
620 W GROVE ST |
| City | EL DORADO |
| State | AR |
| Zip | 71730-4425 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Johnnie Hinton Iii | Nephrology | Arkansas Renal Group Pa | 620 W Grove St, Suite 101, El Dorado, AR 71730-4409 |
| Michael D Schonefeld | Nephrology | Arkansas Renal Group Pa | 620 W Grove St, Suite 101, El Dorado, AR 71730-4409 |
| Lisa B Mcadams | Nurse Practitioner | Arkansas Renal Group Pa | 620 W Grove St, Suite 101, El Dorado, AR 71730-4409 |
| Martha G Garrett Shaver | Family Medicine | South Arkansas Physician Services LLC | 620 W Grove St, El Dorado, AR 71730-4425 |
| Julie N Wylie | Nurse Practitioner | Arkansas Renal Group Pa | 620 W Grove St, Suite 101, El Dorado, AR 71730-4409 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Robert A Watson Ii | Family Medicine | 3108 N W Ave, El Dorado, AR 71730-2731 | |
| Tanya M Golden | Nurse Practitioner | Family Care of Southern Arkansas, Ltd | 3108 N W Ave, El Dorado, AR 71730-2731 |
| Steven T Sowell | Optometry | 2730 N W Ave, El Dorado, AR 71730-3124 | |
| Anita M Burleson | Nurse Practitioner | 1000 N College Ave, El Dorado, AR 71730-3711 | |
| Christie F Skinner | Nurse Practitioner | 1000 N College Ave, El Dorado, AR 71730-3711 | |
| Jerry H Grant | Family Medicine | 1320 N Highland Ave, El Dorado, AR 71730-3929 | |
| Diedra Hayman | Psychologist, Clinical | South Arkansas Regional Health Center | 715 N College Ave, El Dorado, AR 71730-4403 |
| Terri A Rowe | Clinical Social Worker | South Arkansas Regional Health Center | 715 N College Ave, El Dorado, AR 71730-4403 |
| Richard L Sylvester | Psychologist, Clinical | South Arkansas Regional Health Center | 715 N College Ave, El Dorado, AR 71730-4403 |
| Alyssa Dykes | Clinical Social Worker | South Arkansas Regional Health Center | 715 N College Ave, El Dorado, AR 71730-4403 |
| Find all physicians in zip 71730 | |||
| City | EL DORADO |
| Zip Code | 71730 |
| Specialty | OTOLARYNGOLOGY |
| City + Specialty | EL DORADO + OTOLARYNGOLOGY |
Please comment or provide details below to improve the information on Samuel Vallery.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.