Healthcare Provider Details

I. General information

NPI: 1124001953
Provider Name (Legal Business Name): MICHAEL A MCGHEE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/25/2005
Last Update Date: 05/27/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2305 SPRINGHILL RD SUITE 8
BRYANT AR
72019-7552
US

IV. Provider business mailing address

10201 KANIS RD
LITTLE ROCK AR
72205-6203
US

V. Phone/Fax

Practice location:
  • Phone: 501-943-3214
  • Fax: 501-943-3219
Mailing address:
  • Phone: 501-227-5050
  • Fax: 501-227-5151

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License NumberC8454
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: