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General NPI Number Information
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NPI Number | 1255913992
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Entity Type | Individual
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Provider Name | MICHAEL G PAGE DO
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Gender | Male
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Dates
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Enumeration Date | 04/22/2021
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Last Update Date | 06/27/2024
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Provider Practice Location Address
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Address Line | 1617 N WASHINGTON
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City | MAGNOLIA
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State | AR
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Zip | 71753-2046
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Country | US
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Telephone | 870-234-7676
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Fax | 870-562-2559
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Provider Business Mailing Address
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Address Line | PO BOX 251420
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City | LITTLE ROCK
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State | AR
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Zip | 72225-1420
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Country | US
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Telephone | 501-686-8000
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Fax | 501-526-5148
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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 | E-18005
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License Number State | AR
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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