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NPI Code Detail

MEDICARE: DR. DONALD C EWING M.D.

MEDICARE: DR. DONALD C EWING M.D.
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
1207Q00000XFamily Medicine PhysicianE-0441AR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1154329878
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DONALD C EWING M.D.
Provider Business Mailing Address
First Line : 3505 SE 6TH ST
Second Line :
City : BENTONVILLE
State : AR
Zip : 72712-7178
Country : US
Telephone Number : 479-271-7291
Fax Number :
Provider Business Practice Location Address
First Line : 1100 N COLLEGE AVE
Second Line :
City : FAYETTEVILLE
State : AR
Zip : 72703-1944
Country : US
Telephone Number : 479-443-4301
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/07/2005
Last Update Date : 07/08/2007

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