Healthcare Provider Details

I. General information

NPI: 1689237869
Provider Name (Legal Business Name): MARK A FEGER MD PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/15/2019
Last Update Date: 07/11/2025
Certification Date: 07/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

625 UNITED DR STE 350
CONWAY AR
72032-7829
US

IV. Provider business mailing address

11001 EXECUTIVE CENTER DR STE 200
LITTLE ROCK AR
72211-4393
US

V. Phone/Fax

Practice location:
  • Phone: 501-358-6792
  • Fax: 501-358-6841
Mailing address:
  • Phone: 501-812-7512
  • Fax: 501-812-7207

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XS0117X
TaxonomyOrthopaedic Surgery of the Spine Physician
License NumberE19394
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: