Provider Demographics
NPI:1083917520
Name:LEMASTERS MCCORKLE, ERICA
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:
Last Name:LEMASTERS MCCORKLE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2578
Mailing Address - Street 2:
Mailing Address - City:BATESVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72503-2578
Mailing Address - Country:US
Mailing Address - Phone:866-533-1757
Mailing Address - Fax:
Practice Address - Street 1:900 W POPLAR ST STE 200
Practice Address - Street 2:
Practice Address - City:MC CRORY
Practice Address - State:AR
Practice Address - Zip Code:72101-8267
Practice Address - Country:US
Practice Address - Phone:866-533-1757
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-12-06
Last Update Date:2010-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator