MEDICARE: STEPHEN R. MAES 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
1	207RG0300X	Geriatric Medicine (Internal Medicine) Physician	C8283	AR

General Provider Information

NPI Number	:	1245268424
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHEN R. MAES M.D.

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	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/28/2006
Last Update Date	:	07/08/2007

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