Healthcare Provider Details

I. General information

NPI: 1073554929
Provider Name (Legal Business Name): STEPHEN FRANK LEFLER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2006
Last Update Date: 10/06/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 SKYLINE DR MILLARD HENRY CLINIC
RUSSELLVILLE AR
72801-3363
US

IV. Provider business mailing address

105 SKYLINE DR MILLARD HENRY CLINIC
RUSSELLVILLE AR
72801-3363
US

V. Phone/Fax

Practice location:
  • Phone: 479-968-2345
  • Fax: 479-890-2497
Mailing address:
  • Phone: 479-968-2345
  • Fax: 479-890-2497

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License NumberC7115
License Number StateAR
# 2
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberC7115
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: