Healthcare Provider Details

I. General information

NPI: 1821068123
Provider Name (Legal Business Name): STEVEN L EMERSON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/26/2006
Last Update Date: 09/12/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 S CHURCH ST SUITE 302
JONESBORO AR
72401-4176
US

IV. Provider business mailing address

800 S CHURCH ST SUITE 302
JONESBORO AR
72401-4176
US

V. Phone/Fax

Practice location:
  • Phone: 870-935-3990
  • Fax: 870-935-0871
Mailing address:
  • Phone: 870-935-3990
  • Fax: 870-935-0871

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License NumberC6138
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: