MEDICARE: CHASE PLACEK FLOYD MEGGERS

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	367500000X	Certified Registered Nurse Anesthetist
2	207L00000X	Anesthesiology Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1326125113
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHASE PLACEK FLOYD MEGGERS

Provider Business Mailing Address
First Line	:	PO BOX 583
Second Line	:
City	:	LOWELL
State	:	AR
Zip	:	72745-0583
Country	:	US
Telephone Number	:	888-991-1101
Fax Number	:	903-787-5854

Provider Business Practice Location Address
First Line	:	3728 S PINNACLE HILLS PKWY
Second Line	:
City	:	ROGERS
State	:	AR
Zip	:	72758-8897
Country	:	US
Telephone Number	:	479-254-8508
Fax Number	:	479-282-1479

Authorized Official
Title or Position	:	MANAGING MEMBER
Name	:	MR. JEREMY A. BUSH
Credential	:	M.D.
Telephone Number	:	479-236-4956

Provider Enumeration Date	:	11/01/2006
Last Update Date	:	10/30/2024

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