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NPI Code Detail

MEDICARE: ESS OF MCGEHEE LLC

MEDICARE: ESS OF MCGEHEE 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
1207P00000XEmergency Medicine Physician

General Provider Information

NPI Number : 1639822653
Entity Type Code : Organization
Provider Name (Legal Business Name) : ESS OF MCGEHEE LLC
Provider Business Mailing Address
First Line : 17304 PRESTON RD STE 1400
Second Line :
City : DALLAS
State : TX
Zip : 75252-5633
Country : US
Telephone Number : 866-931-8882
Fax Number :
Provider Business Practice Location Address
First Line : 900 S 3RD ST
Second Line :
City : MC GEHEE
State : AR
Zip : 71654-2562
Country : US
Telephone Number : 870-222-5600
Fax Number :
Authorized Official
Title or Position : OWNER
Name : RON WEISS
Credential :
Telephone Number : 866-931-8882
Provider Enumeration Date : 01/31/2022
Last Update Date : 04/14/2022

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Directions to “ESS OF MCGEHEE LLC ” Practice Location

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