Healthcare Provider Details
I. General information
NPI: 1326077801
Provider Name (Legal Business Name): MIKE S MCFARLAND MDPA
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/30/2006
Last Update Date: 08/28/2020
Certification Date: 08/28/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3604 CENTRAL AVE SUITE A
HOT SPRINGS AR
71913-6403
US
IV. Provider business mailing address
3604 CENTRAL AVE SUITE A
HOT SPRINGS AR
71913-6403
US
V. Phone/Fax
- Phone: 870-536-4100
- Fax: 870-534-3982
- Phone: 870-536-4100
- Fax: 870-534-3982
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261Q00000X |
| Taxonomy | Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
AMY
OFFUTT
Title or Position: CONTROLLER
Credential:
Phone: 870-536-4100