Healthcare Provider Details
I. General information
NPI: 1063409878
Provider Name (Legal Business Name): DAVID B SILLS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 10/06/2005
Last Update Date: 12/01/2025
Certification Date: 12/01/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8101 MCCLURE DR # 203
FORT SMITH AR
72916-6057
US
IV. Provider business mailing address
8101 MCCLURE DR STE 203
FORT SMITH AR
72916-6044
US
V. Phone/Fax
- Phone: 792-422-5774
- Fax: 479-434-5987
- Phone: 479-242-2577
- Fax: 479-434-5987
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | R3038 |
| License Number State | AR |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: