Mickey Lawrence Chaudoin | Blytheville, AR • PECOS Search

Mickey Lawrence Chaudoin

Case Manager/Care Coordinator

Other Service Providers

209 S Lockard St, Blytheville, AR 72315-2541

PECOS Enrollment

Based on the most recent information from CMS, provider Mickey Lawrence Chaudoin does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 3 days ago.

Profile Details

Provider ID
1295409431
Provider Type
Individual
Full Name
Chaudoin, Mickey Lawrence
Gender
Male

Sole Proprietor
No
Enumeration Date
8/2/2021
Last Updated
8/2/2021

Contact Information

Practice Location

209 S Lockard St, Blytheville, AR 72315-2541

Unlisted Fax

Mailing Location

2400 S 48th St, Springdale, AR 72762-6683

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 171M00000X Primary	Description Case Manager/Care Coordinator Other Service Providers	License Unlisted Issuer