Healthcare Provider Details

I. General information

NPI: 1235050667
Provider Name (Legal Business Name): MARK CLIFTON JAMES
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/22/2026
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1706 KENSINGTON DR
BRYANT AR
72022-9135
US

IV. Provider business mailing address

1706 KENSINGTON DR
BRYANT AR
72022-9135
US

V. Phone/Fax

Practice location:
  • Phone: 706-289-2260
  • Fax:
Mailing address:
  • Phone: 706-289-2260
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number5559
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: