Healthcare Provider Details

I. General information

NPI: 1518950823
Provider Name (Legal Business Name): FRANK MARTIN MOIX JR. MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: MARTIN MOIX MD

II. Dates (important events)

Enumeration Date: 08/23/2005
Last Update Date: 12/19/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2200 ADA AVE SUITE 201
CONWAY AR
72034-4985
US

IV. Provider business mailing address

2200 ADA AVE SUITE 201
CONWAY AR
72034-4985
US

V. Phone/Fax

Practice location:
  • Phone: 501-932-0282
  • Fax: 501-932-0284
Mailing address:
  • Phone: 501-932-0282
  • Fax: 501-932-0284

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberE1456
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: