Healthcare Provider Details

I. General information

NPI: 1881605947
Provider Name (Legal Business Name): MIKE S. MCFARLAND MDPA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/11/2006
Last Update Date: 06/24/2024
Certification Date: 06/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10700 N RODNEY PARHAM RD STE C-1A
LITTLE ROCK AR
72212-4191
US

IV. Provider business mailing address

17200 CHENAL PKWY SUITE 440
LITTLE ROCK AR
72223-5944
US

V. Phone/Fax

Practice location:
  • Phone: 501-830-2020
  • Fax: 501-830-2021
Mailing address:
  • Phone: 501-830-2020
  • Fax: 501-830-2021

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: AMY OFFUTT
Title or Position: CONTROLLER
Credential:
Phone: 870-536-4100