Provider Demographics
NPI:1538152699
Name:PRICE, JOHN G (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:G
Last Name:PRICE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2000 S 42ND ST
Mailing Address - Street 2:STE 100
Mailing Address - City:ROGERS
Mailing Address - State:AR
Mailing Address - Zip Code:72758-2001
Mailing Address - Country:US
Mailing Address - Phone:479-273-9173
Mailing Address - Fax:479-464-9989
Practice Address - Street 1:2000 S 42ND ST
Practice Address - Street 2:STE 100
Practice Address - City:ROGERS
Practice Address - State:AR
Practice Address - Zip Code:72758-2001
Practice Address - Country:US
Practice Address - Phone:479-273-9173
Practice Address - Fax:479-464-9989
Is Sole Proprietor?:No
Enumeration Date:2005-08-24
Last Update Date:2020-09-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ARC8459207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR128801001Medicaid
AR5J963OtherAR BLUE CROSS BLUE SHIELD
AR128801001Medicaid