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General NPI Number Information
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NPI Number | 1174523120
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Entity Type | Individual
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Provider Name | MARTY WAYNE HEARYMAN MD
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Gender | Male
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Dates
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Enumeration Date | 07/29/2005
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Last Update Date | 08/12/2024
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Provider Practice Location Address
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Address Line | 309 EAST RACE AVE
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City | SEARCY
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State | AR
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Zip | 72143-4331
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Country | US
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Telephone | 501-209-8232
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Fax |
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Provider Business Mailing Address
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Address Line | 1019 GOLF COURSE DR
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City | SEARCY
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State | AR
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Zip | 72143-4565
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Country | US
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Telephone | 501-209-8232
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | E2849
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License Number State | AR
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