Healthcare Provider Details

I. General information

NPI: 1225018518
Provider Name (Legal Business Name): MIRFAT BIRD M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/20/2006
Last Update Date: 09/26/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

426 HOSPITAL DR
CAMDEN AR
71701-4616
US

IV. Provider business mailing address

426 HOSPITAL DR
CAMDEN AR
71701-4616
US

V. Phone/Fax

Practice location:
  • Phone: 870-836-6820
  • Fax: 870-836-6827
Mailing address:
  • Phone: 870-836-6820
  • Fax: 870-836-6827

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberE0012
License Number StateAR
# 2
Primary TaxonomyN
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License NumberE0012
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: