ABDUL KADER EZELDIN (NPI# 1639129133) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639129133 |
| Entity Type | Individual |
| Full Name | ABDUL KADER EZELDIN |
| Credential | MD |
| Practice Address |
1 Medical Park Dr Benton AR 72015-3353 |
| Mailing Address |
1801 W 40th Ave Ste 5c Pine Bluff AR 71603-6962 |
| Practice Telephone | 5017766000 |
| Mailing Telephone | 8705341726 |
| Mailing Fax Number | 8705340728 |
| Enumeration Date | 2006-05-12 |
| Last Update Date | 2020-09-30 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
E3462 | AR | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AR | 148801001 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1801 W 40th Ave Ste 5c, Pine Bluff, AR 716036962 | 8705341726 | 8705340728 |
| Street Address |
1 MEDICAL PARK DR |
| City | BENTON |
| State | AR |
| Zip Code | 72015-3353 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942808217 | Megan Wheat | Nurse Practitioner | 1 Medical Park Dr, Benton, AR 72015-3353 | 2020-10-09 |
| 1861019721 | Traci C Crump | Nurse Practitioner | 1 Medical Park Dr, Benton, AR 72015-3353 | 2020-06-26 |
| 1669091195 | Jessica Lee Roper | Nurse Practitioner | 1 Medical Park Dr, Benton, AR 72015-3353 | 2020-04-14 |
| 1134767627 | Penny Kaye Bettis | Nurse Practitioner | 1 Medical Park Dr, Benton, AR 72015-3353 | 2019-12-15 |
| 1598328163 | Rachel Catherine Huynh | Nurse Practitioner | 1 Medical Park Dr, Benton, AR 72015-3353 | 2019-04-18 |
| 1154889707 | Panfilo Estrada-flores | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1 Medical Park Dr, Benton, AR 72015-3353 | 2019-03-03 |
| 1063976389 | Mackenzie Cole | Physician Assistant | 1 Medical Park Dr, Benton, AR 72015-3353 | 2019-01-31 |
| 1396224002 | Devin Annette Devlin | Nurse Practitioner | 1 Medical Park Dr, Benton, AR 72015-3353 | 2018-08-13 |
| 1679084404 | Lindsay Queen | Dietitian, Registered | 1 Medical Park Dr, Benton, AR 72015-3353 | 2017-10-19 |
| 1073031878 | Jennifer Faughn Neighbors | Nurse Practitioner | 1 Medical Park Dr, Benton, AR 72015-3353 | 2017-09-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790343135 | Justin King | Case Manager/Care Coordinator | 1502 Mary Kay Blv6, Benton, AR 72015 | 2019-05-31 |
| 1790253326 | Seth Alexander Weisheit | Nurse Practitioner | 824 Military Road, Benton, AR 72015 | 2018-11-13 |
| 1396269627 | Abby G Sims | Speech-Language Pathologist | 3391 Peachtree Lane, Benton, AR 72015 | 2017-07-28 |
| 1225551278 | Jessica R Poe | Case Manager/Care Coordinator | 1502 Marykay Blvd, Benton, AR 72015 | 2017-07-21 |
| 1003357997 | Jamaal Langston | Case Manager/Care Coordinator | 1502 Mark Kay Blvd, Benton, AR 72015 | 2017-03-13 |
| 1881138550 | Shannon Gachot-ridgley | Counselor | 205 South Street Suite 3, Benton, AR 72015 | 2016-12-14 |
| 1295104578 | Excel Health of Haskell, Pllc | Clinical Nurse Specialist | 6029 Us Hwy 67, Haskell, AR 72015 | 2015-09-17 |
| 1528464054 | Kacey Jo Kiker | Nurse Practitioner | 620 W South St, Benton, AR 72015 | 2014-11-11 |
| 1700218252 | Jamie Brunt | Licensed Practical Nurse | 1718 Old Hot Springs Rd, Benton, AR 72015 | 2013-08-07 |
| 1760738942 | Kari J Richards | Physical Therapist | 5701 Springhill Rd, Bryant, AR 72015 | 2012-07-25 |
| Find all providers in zip 72015 | ||||
| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497746390 | Christopher J Ostromecki | Internal Medicine | 203 Bailey Ln, Benton, IL 62812-2270 | 2005-10-31 |
| 1508215880 | Ornish Reversal Program Tm At Saline Heart Group LLC | Internal Medicine | 1000 Hwy 35 N, Suite 8, Benton, AR 72019-2351 | 2016-06-08 |
| 1780913822 | Saline Physician Services, LLC | Internal Medicine | 1 Medical Park Dr, Benton, AR 72015-3353 | 2009-12-21 |
| 1164414462 | Paul John Baxley | Internal Medicine | 1000 Highway 35 N, Suite 8, Benton, AR 72019-2351 | 2005-08-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316580996 | Hmdod LLC | Internal Medicine | 403 W Oak St Ste 101, El Dorado, AR 71730-4573 | 2019-10-25 |
| 1316426125 | Baptist Health Services | Internal Medicine | 1500 Dodson Ave Ste 60, Fort Smith, AR 72901 | 2018-08-13 |
| 1083160899 | Baptist Health | Internal Medicine | 625 United Dr, Suite 220, Conway, AR 72032-7826 | 2016-08-31 |
| 1467820928 | Octavio Herrera-verdugo | Internal Medicine | 1225 Breckenridge Dr Ste 110, Little Rock, AR 72205-1565 | 2015-09-14 |
| 1225389588 | Van Buren Hma, LLC | Internal Medicine | 2010 Chestnut St Ste 1, Van Buren, AR 72956-5321 | 2012-09-27 |
| 1902163389 | Central Arkansas Heart Center | Internal Medicine | 650 United Drive, Ste 300, Conway, AR 72032 | 2012-04-23 |
| 1356635411 | Mercy Health Northwest Arkansas Communities | Internal Medicine | 2790 Bella Vista Way, Bella Vista, AR 72714-3706 | 2011-06-07 |
| 1124317854 | Wesley Martin Fiser | Internal Medicine | 9501 Baptist Health Dr Ste 600, Little Rock, AR 72205 | 2011-04-04 |
| 1821307943 | James William Wilson | Internal Medicine | 1000 Miller Creek Rd., Batesville, AR 72501 | 2010-10-07 |
| 1861706046 | Yazan Zuhair Ghosheh | Internal Medicine | 4000 Richards Rd Ste A, North Little Rock, AR 72117-2939 | 2010-07-30 |
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| 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.