MEDICARE: MEDCITY WELLNESS & REHAB 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
1	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1437921335
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEDCITY WELLNESS & REHAB LLC

Provider Business Mailing Address
First Line	:	403 W OAK ST STE 101
Second Line	:
City	:	EL DORADO
State	:	AR
Zip	:	71730-4573
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	403 W OAK ST STE 101
Second Line	:
City	:	EL DORADO
State	:	AR
Zip	:	71730-4573
Country	:	US
Telephone Number	:	870-875-1481
Fax Number	:

Authorized Official
Title or Position	:	MD
Name	:	VIKRAMJIT SINGH
Credential	:
Telephone Number	:	412-721-7618

Provider Enumeration Date	:	10/24/2023
Last Update Date	:	10/24/2023

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