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NPI Code Detail

MEDICARE: PULASKI EMERGENCY GROUP LLC

MEDICARE: PULASKI EMERGENCY GROUP LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363AM0700XMedical Physician Assistant
2363L00000XNurse Practitioner
3207P00000XEmergency Medicine Physician

General Provider Information

NPI Number : 1174509673
Entity Type Code : Organization
Provider Name (Legal Business Name) : PULASKI EMERGENCY GROUP LLC
Provider Business Mailing Address
First Line : 200 CORPORATE BLVD
Second Line : SUITE 201
City : LAFAYETTE
State : LA
Zip : 70508-3870
Country : US
Telephone Number : 800-893-9698
Fax Number :
Provider Business Practice Location Address
First Line : 1400 BRADEN ST
Second Line :
City : JACKSONVILLE
State : AR
Zip : 72076-3721
Country : US
Telephone Number : 501-985-7000
Fax Number :
Authorized Official
Title or Position : CEO
Name : DR. WILLIAM CLIFF SCHUMACHER
Credential : M.D.
Telephone Number : 337-237-1915
Provider Enumeration Date : 12/16/2005
Last Update Date : 10/10/2007

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Directions to “PULASKI EMERGENCY GROUP LLC ” Practice Location

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