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NPI Code Detail

MEDICARE: CYRIL E SEVERNS MD

MEDICARE: CYRIL E SEVERNS MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207N00000XDermatology PhysicianE2217AR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1013904176
Entity Type Code : Individual
Provider Name (Legal Business Name) : CYRIL E SEVERNS MD
Provider Business Mailing Address
First Line : 7900 DALLAS ST
Second Line :
City : FORT SMITH
State : AR
Zip : 72903-5690
Country : US
Telephone Number : 479-242-6647
Fax Number : 479-250-0505
Provider Business Practice Location Address
First Line : 7900 DALLAS ST
Second Line :
City : FORT SMITH
State : AR
Zip : 72903-5690
Country : US
Telephone Number : 479-242-6647
Fax Number : 479-250-0505
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/04/2005
Last Update Date : 03/06/2023

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Directions to “ CYRIL E SEVERNS MD” Practice Location

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