SUDESH BANAJI MD PLLC (NPI# 1639319411) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639319411 |
| Entity Type | Organization |
| Organization Name | SUDESH BANAJI MD PLLC |
| Other Organization Name | EARLE FAMILY MEDICAL CLINIC |
| Practice Address |
1605 Second Street Earle AR 72331-1634 |
| Mailing Address |
332 E Cook St Forrest City AR 72335-2830 |
| Practice Telephone | 8707928825 |
| Practice Fax Number | 8707928834 |
| Mailing Telephone | 8706302233 |
| Mailing Fax Number | 8706302224 |
| Enumeration Date | 2009-03-06 |
| Last Update Date | 2014-05-16 |
| Authorized Official Name | MR. SUDESH BANAJI (OWNER) |
| Authorized Official Telephone | 8707928825 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| N | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| Y | 261QR1300X |
Clinic/Center Specialization: Rural Health |
E2405 | AR | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Earle Family Medical Clinic | Doing Business As Name - Organization |
| Street Address |
1605 SECOND STREET |
| City | EARLE |
| State | AR |
| Zip Code | 72331-1634 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508082074 | Hyter Rezell Alexander | Counselor | 320 Lee Street, Earle, AR 72331 | 2007-04-17 |
| 1225185499 | Rhonda Laster | Counselor | 320 Lee Ave, Earle, AR 72331 | 2007-01-03 |
| 1437367745 | Earle School District | Speech-Language Pathologist | 1401 3rd St, Earle, AR 72331-1353 | 2007-05-18 |
| 1942418819 | Hyman Vision Clinic | Optometrist | 710 Commerce St, Earle, AR 72331-1419 | 2007-05-21 |
| 1619051737 | Fongs Drugs | Pharmacy | 621 Commerce St, Earle, AR 72331-1616 | 2006-10-25 |
| 1649734310 | Carol Riley Clark | Pharmacist | 621 Commerce St, Earle, AR 72331-1616 | 2019-01-28 |
| 1841321940 | Carol Clark | Pharmacy | 621 Commerce St, Earle, AR 72331-1616 | 2007-03-08 |
| 1619011186 | Jessie J Fong | Pharmacist | 621 Commerce St, Earle, AR 72331-1616 | 2007-02-17 |
| 1205899572 | Purnima Sarkar | Internal Medicine | 1605 2nd St, Earle, AR 72331-1634 | 2006-04-08 |
| 1316593122 | Marka Morgan Ahrent | Nurse Practitioner | 1605 2nd St, Earle, AR 72331-1634 | 2019-08-16 |
| Find all providers in zip 72331 | ||||
| Taxonomy Code | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
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| 1154945483 | Sgoh Acquisition Inc | Clinic/Center | 102 Russell Road, Rogers, AR 72756 | 2020-06-02 |
| 1710465190 | Arcare | Clinic/Center | 3150 E. Heritage Parkway, Farmington, AR 72753 | 2018-07-30 |
| 1043716525 | Mmc Rural Health Clinics, Pllc | Clinic/Center | 733 Roberts Drive, Monticello, AR 71655 | 2018-04-03 |
| 1316443807 | Mmc Rural Health Clinics, Pllc | Clinic/Center | 1306 North Lincoln Avenue, Star City, AR 71667 | 2018-04-03 |
| 1124539648 | Access Medical Clinic Arkansas LLC | Clinic/Center | 1016 North Fourche Avenue, Perryville, AR 72126 | 2017-10-24 |
| 1174044697 | Bradley County Medical Center Rural Health Clinic | Clinic/Center | 304 East Central, Warren, AR 71671-0000 | 2017-07-06 |
| 1144755570 | Access Medical Clinic Arkansas LLC | Clinic/Center | 16723 Hwy 62, Garfield, AR 72732 | 2017-04-24 |
| 1568904480 | Bradley Bibb, Md Pllc | Clinic/Center | 1176 State Highway 22 W Ste B, Dardanelle, AR 72834 | 2016-11-09 |
| Find all providers with the same taxonomy | ||||
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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.