REX EDWARD LUTTRELL MD PA


Address: 1300 Braden St, Pod B, Jacksonville, AR 72076-3719
Phone: 5019784343

REX EDWARD LUTTRELL MD PA (NPI# 1548276223) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1548276223
Entity Type Organization
Organization Name REX EDWARD LUTTRELL MD PA
Practice Address 1300 Braden St
Pod B
Jacksonville
AR 72076-3719
Mailing Address Po Box 5209
Jacksonville
AR 72078-5209
Practice Telephone 5019784343
Practice Fax Number 5019758995
Mailing Telephone 5019784343
Mailing Fax Number 5019758995
Enumeration Date 2006-08-01
Last Update Date 2009-08-25
Authorized Official Name REX E LUTTRELL (OWNER)
Authorized Official Telephone 5019784343
Authorized Official Credential MD
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 208600000X Surgery MC2274 AR Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
AR 149546002 05

Office Location

Street Address 1300 BRADEN ST
POD B
City JACKSONVILLE
State AR
Zip Code 72076-3719

Providers in the same location

NPI Name Taxonomy Address Enumeration
1689679169 Physicians Network Inc. Internal Medicine 1300 Braden St, Jacksonville, AR 72076-3719 2005-06-20
1508414152 Marsha Moore Bertasi Occupational Therapist 1300 Braden St, Jacksonville, AR 72076-3719 2019-08-27
1093161069 Drew Siebenmorgen Physician Assistant 1300 Braden St, Jacksonville, AR 72076-3719 2016-05-10
1043681349 John Glenn Physical Therapist 1300 Braden St, Jacksonville, AR 72076-3719 2015-10-13
1144691445 Jason Johnson Physical Therapist 1300 Braden St, Jacksonville, AR 72076-3719 2015-10-13
1730550203 Farrer Physical Therapy Inc Physical Therapist 1300 Braden St, Jacksonville, AR 72076-3719 2015-10-09
1396130431 John David Wilkins Family Medicine 1300 Braden St, Jacksonville, AR 72076-3719 2015-04-06
1548671407 Hejny Enterprises Inc. Pharmacy 1300 Braden St, Jacksonville, AR 72076-3719 2014-05-14
1710306089 Aaron Roberds Family Medicine 1300 Braden St, Jacksonville, AR 72076-3719 2014-04-15
1407810898 Mark A Peterson Family Medicine 1300 Braden St, Jacksonville, AR 72076-3719 2006-04-13
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1598396046 Jennifer Michelle Price Licensed Practical Nurse 2400 West Main, Jacksonville, AR 72076 2020-02-03
1912464009 Stat Home Health - Cenark LLC Home Health 1410 Braden Street, Jacksonville, AR 72076 2019-02-25
1649797671 Caring Hearts Counseling, LLC Case Management 111 Marble Drive, Jacksonville, AR 72076 2017-08-30
1376071340 Anne Elizabeth Houtchens Speech-Language Pathologist 2701 Tp White Drive, Jacksonville, AR 72076 2017-06-02
1881140648 Jacksonville North Pulaski School District Local Education Agency (LEA) 1414 West Main, Jacksonville, AR 72076 2016-08-31
1134599772 Jeremiah Melson Fleeman Occupational Therapist 2701 Tpwhite Drive, Jacksonville, AR 72076 2015-09-25
1821424565 Kasey Michele Leeson Social Worker 2520 W. Main St., Jacksonville, AR 72076 2013-09-25
1407104052 Cesalie Deonne Wallace Nurse Practitioner 3000 North First Street, Jacksonville, AR 72076 2012-08-29
1952660995 Joshua Aaron Hill Case Manager/Care Coordinator 2126 N. 1st St Suite F, Jacksonville, AR 72076 2012-05-11
1396023156 Syreeta Tucker Case Manager/Care Coordinator 1109 Burman, Jacksonville, AR 72076 2011-07-28
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Taxonomy Information

Taxonomy Code 208600000X
Grouping Allopathic & Osteopathic Physicians
Classification Surgery

Taxonomy Definition

A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source]
- Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1003441981 Comprehensive Care Partners Surgery 3101 University Blvd S Ste 100, Jacksonville, FL 32216-2750 2020-03-11
1922577626 Grettel Wentling Surgery 7915 Turnstone Cir E, Jacksonville, FL 32256-2358 2018-11-26
1083030977 Min Li Xu Surgery 2 Shircliff Way Ste 500, Jacksonville, FL 32204-4763 2014-03-15
1518300128 Michel Joseph Sabra Surgery 5053 Toproyal Ln, Jacksonville, FL 32277 2013-04-12
1437414935 Daniel Richard Martin Surgery 4205 Belfort Rd Ste 3030, Jacksonville, FL 32216-1474 2012-07-10
1356602221 Jan-michael Van Gent Surgery Navy Medicine Support Command Attn: Medical Staff Serv., Bldg H 2005 Knight Lane, Jacksonville, FL 32212-0140 2012-06-06
1710245840 Lenka Zachar Md Plc Surgery 3 Shircliff Way Ste 500, Jacksonville, FL 32204-4757 2012-04-26
1992015812 Ashok Roychoudhury, M.d., P.a. Surgery 2032a Southside Blvd, Jacksonville, FL 32216-1944 2010-10-13
1558682054 Jonathan Robert Gower Surgery Bldg H 2005 Knight Lane, Attn: Medical Staff Services, Navy Medicine Support Command, Jacksonville, FL 32212-0140 2010-06-18
1851612683 Jason Bradley Brill Surgery Bldg H 2005 Knight Ln, Navy Medicine Support Command, Attn Medical Staff Serv, Jacksonville, FL 32212 2010-06-16
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Competitor

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City JACKSONVILLE
Zip Code 72076

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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