MEDICARE: LESTER E COX MEDICAL CENTERS

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	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1629690581
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LESTER E COX MEDICAL CENTERS

Provider Business Mailing Address
First Line	:	PO BOX 7411626
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60674-5626
Country	:	US
Telephone Number	:	417-730-6430
Fax Number	:	417-269-7567

Provider Business Practice Location Address
First Line	:	1401 HIGHWAY 62 65 N STE 200
Second Line	:
City	:	HARRISON
State	:	AR
Zip	:	72601-1701
Country	:	US
Telephone Number	:	870-743-9744
Fax Number	:	870-743-9746

Authorized Official
Title or Position	:	VP REGIONAL SERVICES
Name	:	BROCK SHAMEL
Credential	:
Telephone Number	:	417-269-4368

Provider Enumeration Date	:	05/14/2020
Last Update Date	:	02/16/2026

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Directions to “LESTER E COX MEDICAL CENTERS ” Practice Location

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