Healthcare Provider Details

I. General information

NPI: 1134105042
Provider Name (Legal Business Name): ERIC EUGENE BELIN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/22/2005
Last Update Date: 11/03/2025
Certification Date: 11/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14 RIORDAN RD
BELLA VISTA AR
72714-3516
US

IV. Provider business mailing address

1651 E STEARNS ST STE 110
FAYETTEVILLE AR
72703-6196
US

V. Phone/Fax

Practice location:
  • Phone: 479-876-8550
  • Fax: 479-208-4266
Mailing address:
  • Phone: 479-876-8550
  • Fax: 479-208-4266

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberE-11890
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: