Provider Demographics
NPI:1295104578
Name:EXCEL HEALTH OF HASKELL, PLLC
Entity type:Organization
Organization Name:EXCEL HEALTH OF HASKELL, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHIRLEY
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:501-223-2776
Mailing Address - Street 1:6029 HIGHWAY 67
Mailing Address - Street 2:
Mailing Address - City:HASKELL
Mailing Address - State:AR
Mailing Address - Zip Code:72015-8400
Mailing Address - Country:US
Mailing Address - Phone:501-794-6808
Mailing Address - Fax:884-272-1481
Practice Address - Street 1:6029 US HWY 67
Practice Address - Street 2:
Practice Address - City:HASKELL
Practice Address - State:AR
Practice Address - Zip Code:72015
Practice Address - Country:US
Practice Address - Phone:501-847-3292
Practice Address - Fax:501-213-0573
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-17
Last Update Date:2016-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes364SF0001XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistFamily HealthGroup - Single Specialty