Healthcare Provider Details

I. General information

NPI: 1790820520
Provider Name (Legal Business Name): MARK RAMIRO, M.D.,P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/20/2007
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4303 S MULBERRY ST
PINE BLUFF AR
71603-7017
US

IV. Provider business mailing address

4303 S MULBERRY ST
PINE BLUFF AR
71603-7017
US

V. Phone/Fax

Practice location:
  • Phone: 870-247-9499
  • Fax: 870-247-9495
Mailing address:
  • Phone: 870-247-9499
  • Fax: 870-247-5312

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberE2876
License Number StateAR

VIII. Authorized Official

Name: CINDY M LIVINGSTON
Title or Position: CLINIC MANAGER
Credential:
Phone: 870-247-9499