MEDICARE: CORNERSTONE MEDICAL GROUP, PLLC

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	:	1811100910
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CORNERSTONE MEDICAL GROUP, PLLC

Provider Business Mailing Address
First Line	:	825 HWY. 71 N.
Second Line	:
City	:	ALMA
State	:	AR
Zip	:	72921-5114
Country	:	US
Telephone Number	:	479-632-6688
Fax Number	:	479-632-0055

Provider Business Practice Location Address
First Line	:	825 HWY 71 NORTH
Second Line	:
City	:	ALMA
State	:	AR
Zip	:	72921-5061
Country	:	US
Telephone Number	:	479-632-6688
Fax Number	:	479-632-0055

Authorized Official
Title or Position	:	OFFICER
Name	:	DR. JAVED A RANA
Credential	:	M.D.
Telephone Number	:	479-632-6688

Provider Enumeration Date	:	05/07/2007
Last Update Date	:	12/06/2011

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