Provider Demographics
NPI:1295868263
Name:JOE ABRAMS, MD PA
Entity Type:Organization
Organization Name:JOE ABRAMS, MD PA
Other - Org Name:FAMILY DOCTORS CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOE
Authorized Official - Middle Name:A
Authorized Official - Last Name:ABRAMS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:501-843-6528
Mailing Address - Street 1:PO BOX 1330
Mailing Address - Street 2:
Mailing Address - City:CABOT
Mailing Address - State:AR
Mailing Address - Zip Code:72023-1330
Mailing Address - Country:US
Mailing Address - Phone:501-843-6528
Mailing Address - Fax:501-843-0144
Practice Address - Street 1:105 N JACKSON ST
Practice Address - Street 2:
Practice Address - City:CABOT
Practice Address - State:AR
Practice Address - Zip Code:72023-3058
Practice Address - Country:US
Practice Address - Phone:501-843-6528
Practice Address - Fax:501-843-0144
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-13
Last Update Date:2008-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARC4794207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR102551001Medicaid
AR50012OtherBLUE CROSSBLUE SHIELD
AR4561544OtherAETNA ID
AR111790000-00OtherQUALCHOICE
AR111790000-00OtherQUALCHOICE