Healthcare Provider Details

I. General information

NPI: 1568495638
Provider Name (Legal Business Name): DARWIN MARTIN KOLLER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/09/2006
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2601 GENE GEORGE BLVD
SPRINGDALE AR
72762-0845
US

IV. Provider business mailing address

2601 GENE GEORGE BLVD
SPRINGDALE AR
72762-0845
US

V. Phone/Fax

Practice location:
  • Phone: 479-725-6800
  • Fax: 479-725-6582
Mailing address:
  • Phone: 479-725-6800
  • Fax: 479-725-6582

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0204X
TaxonomyPediatric Emergency Medicine (Pediatrics) Physician
License NumberE-18596
License Number StateAR
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD39891
License Number StateTN
# 3
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number39891
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: