Provider Demographics
NPI:1558448357
Name:CHASE, PATRICK R (MD)
Entity type:Individual
Prefix:
First Name:PATRICK
Middle Name:R
Last Name:CHASE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 583
Mailing Address - Street 2:
Mailing Address - City:LOWELL
Mailing Address - State:AR
Mailing Address - Zip Code:72745-0583
Mailing Address - Country:US
Mailing Address - Phone:888-991-1101
Mailing Address - Fax:903-787-5854
Practice Address - Street 1:3728 S PINNACLE HILLS PKWY
Practice Address - Street 2:
Practice Address - City:ROGERS
Practice Address - State:AR
Practice Address - Zip Code:72758-8897
Practice Address - Country:US
Practice Address - Phone:479-254-8508
Practice Address - Fax:479-282-1479
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2024-10-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ARC-6190207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100177940AMedicaid
AR105353001Medicaid
AR105353001Medicaid
OK100177940AMedicaid
O50027500Medicare PIN