Healthcare Provider Details

I. General information

NPI: 1326125113
Provider Name (Legal Business Name): CHASE PLACEK FLOYD MEGGERS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 10/30/2024
Certification Date: 10/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3728 S PINNACLE HILLS PKWY
ROGERS AR
72758-8897
US

IV. Provider business mailing address

PO BOX 583
LOWELL AR
72745-0583
US

V. Phone/Fax

Practice location:
  • Phone: 479-254-8508
  • Fax: 479-282-1479
Mailing address:
  • Phone: 888-991-1101
  • Fax: 903-787-5854

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. JEREMY A. BUSH
Title or Position: MANAGING MEMBER
Credential: M.D.
Phone: 479-236-4956