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General NPI Number Information
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NPI Number | 1750489589
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Entity Type | Individual
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Provider Name | ERNEST MAK M.D.
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Gender | Male
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Dates
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Enumeration Date | 09/20/2006
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Last Update Date | 07/30/2013
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Provider Practice Location Address
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Address Line | 1803 MARTIN LUTHER KING JR DR SUITE D
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City | HELENA
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State | AR
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Zip | 72342-8998
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Country | US
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Telephone | 870-816-3800
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Fax | 870-816-3801
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Provider Business Mailing Address
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Address Line | 1803 MARTIN LUTHER KING JR DR SUITE D
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City | HELENA
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State | AR
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Zip | 72342-8998
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Country | US
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Telephone | 870-816-3800
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Fax | 870-816-3801
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 41742
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | E-0301
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License Number State | AR
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