MEDICARE: STEPHEN R. MAES, M.D., P.A.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	C8283	AR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MC-2241	OTHER	AR	CORP MEDICAL LICENSE

General Provider Information

NPI Number	:	1134242191
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STEPHEN R. MAES, M.D., P.A.

Provider Business Mailing Address
First Line	:	825 N SPRING ST
Second Line	:	SUITE F
City	:	HARRISON
State	:	AR
Zip	:	72601-2942
Country	:	US
Telephone Number	:	870-741-8800
Fax Number	:	870-741-4545

Provider Business Practice Location Address
First Line	:	825 N SPRING ST
Second Line	:	SUITE F
City	:	HARRISON
State	:	AR
Zip	:	72601-2942
Country	:	US
Telephone Number	:	870-741-8800
Fax Number	:	870-741-4545

Authorized Official
Title or Position	:	PHYSICIAN OWNER
Name	:	STEPHEN R. MAES
Credential	:	M.D.
Telephone Number	:	870-741-8800

Provider Enumeration Date	:	04/06/2007
Last Update Date	:	08/22/2020

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