Healthcare Provider Details

I. General information

NPI: 1518896364
Provider Name (Legal Business Name): MARLEIGH DIETZ PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/18/2026
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

103 N DIXIELAND RD
ROGERS AR
72756-3203
US

IV. Provider business mailing address

103 N DIXIELAND RD
ROGERS AR
72756-3203
US

V. Phone/Fax

Practice location:
  • Phone: 479-631-7013
  • Fax:
Mailing address:
  • Phone: 479-209-5518
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPD16698
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: