Healthcare Provider Details

I. General information

NPI: 1437755220
Provider Name (Legal Business Name): JAMES MATTHEW STILL PHARMD.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/08/2020
Last Update Date: 12/08/2020
Certification Date: 12/08/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2894 W SUNSET AVE
SPRINGDALE AR
72762-4940
US

IV. Provider business mailing address

568 SHORES AVE
CAVE SPRINGS AR
72718-9687
US

V. Phone/Fax

Practice location:
  • Phone: 479-751-0882
  • Fax: 479-872-0646
Mailing address:
  • Phone: 479-409-8950
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835C0205X
TaxonomyCritical Care Pharmacist
License NumberPD09145
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: