Thomas R Braswell (NPI# 1164448858, PAC ID# 7517969199) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY MEDICINE.
Nation Provider ID (NPI) | 1164448858 |
PAC ID by PECOS | 7517969199 |
Professional Enrollment ID | I20070212000076 |
Full Name | Thomas R Braswell |
Organization Legal Name | ST VINCENT MEDICAL GROUP |
Address |
St Vincent Medical Clinic-scott 15111 Highway 165 Scott AR 72142 |
Phone Number | 5015527999 |
Gender | M |
Credential | MD |
Medical School | UNIVERSITY OF ARKANSAS COLLEGE OF MEDICINE |
Graduation Year | 1978 |
Primary Specialty | FAMILY MEDICINE |
Group Practice PAC ID | 5698758803 |
Number of Group Practice Members | 123 |
Accepts Medicare Assignment | Y |
Claim Control Number (CCN) | Legal Business Name |
---|---|
040036 | BAPTIST HEALTH MEDICAL CENTER NORTH LITTLE ROCK |
Address | Phone | Organization |
---|---|---|
St Vincent Medical Clinic-scott, 15111 Highway 165, Scott, AR 72142 | 5015527999 | ST VINCENT MEDICAL GROUP |
Organization Legal Name | ST VINCENT MEDICAL GROUP |
Physicians | 116 |
Name | Specialty | Organization | Address |
---|---|---|---|
Chen Wang | Family Medicine | St Vincent Medical Group | 4202 S University Ave, Little Rock, AR 72204-7841 |
Kimberly A Browning | Nurse Practitioner | St Vincent Medical Group | 3025 Fountain Dr, Suite 100, Conway, AR 72034-3690 |
Teresa M Whitwell | Nurse Practitioner | St Vincent Medical Group | 4000 Richards Rd, Suite B, North Little Rock, AR 72117-2939 |
Whitney N Reed | Nurse Practitioner | St Vincent Medical Group | St Vincent Medical Clinic- Lonoke, 130 Jf Blvd, Lonoke, AR 72086-9365 |
Lara Sanders | Nurse Practitioner | St Vincent Medical Group | 7709 Hwy 107, Sherwood, AR 72120-4661 |
Vyjayanthi Ganga | Internal Medicine | St Vincent Medical Group | 2500 E 6th St, Health Clinic East, Little Rock, AR 72202-3008 |
Ali Raja | Neurosurgery | St Vincent Medical Group | 6020 Warden Rd, 100 Arkansas Neuroscience Institute, Sherwood, AR 72120-6068 |
Paul E Valentin-stone | Internal Medicine | St Vincent Medical Group | 1401 Braden St, Jacksonville, AR 72076-3720 |
Rayburn F Rego | Gastroenterology | St Vincent Medical Group | 417 N University Ave, Little Rock, AR 72205-3108 |
Lori Fawbush | Nurse Practitioner | St Vincent Medical Group | 15033 Hwy 165, Scott, AR 72142-9555 |
Street Address |
ST VINCENT MEDICAL CLINIC-SCOTT 15111 HIGHWAY 165 |
City | SCOTT |
State | AR |
Zip | 72142 |
Name | Specialty | Organization | Address |
---|---|---|---|
Aleobe Eruemulor | Family Medicine | St Vincent Medical Group | St Vincent Medical Clinic-scott, 15111 Highway 165, Scott, AR 72142 |
Name | Specialty | Organization | Address |
---|---|---|---|
Lori Fawbush | Nurse Practitioner | St Vincent Medical Group | 15033 Hwy 165, Scott, AR 72142-9555 |
City | SCOTT |
Zip Code | 72142 |
Specialty | FAMILY MEDICINE |
City + Specialty | SCOTT + FAMILY MEDICINE |
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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.