Healthcare Provider Details
I. General information
NPI: 1679878854
Provider Name (Legal Business Name): JAMES D SHARP MD PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/19/2011
Last Update Date: 01/19/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
601 W MAPLE AVE SUITE 205A
SPRINGDALE AR
72764-5335
US
IV. Provider business mailing address
601 W MAPLE AVE SUITE 205A
SPRINGDALE AR
72764-5335
US
V. Phone/Fax
- Phone: 479-419-9393
- Fax: 479-419-9513
- Phone: 479-419-9393
- Fax: 479-419-9513
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207W00000X |
| Taxonomy | Ophthalmology Physician |
| License Number | C-4526 |
| License Number State | AR |
VIII. Authorized Official
Name: DR.
JAMES
D
SHARP
Title or Position: OWNER
Credential: MD
Phone: 479-419-9393