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1568495638

NPI Code Detail

MEDICARE: DR. DARWIN MARTIN KOLLER M.D.

MEDICARE: DR. DARWIN MARTIN KOLLER M.D.

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
1	2080P0204X	Pediatric Emergency Medicine (Pediatrics) Physician	E-18596	AR
2	208000000X	Pediatrics Physician	MD39891	TN
3	207P00000X	Emergency Medicine Physician	39891	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	4110137	OTHER	TN	BLUE CROSS

General Provider Information

NPI Number	:	1568495638
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DARWIN MARTIN KOLLER M.D.

Provider Business Mailing Address
First Line	:	2601 GENE GEORGE BLVD
Second Line	:
City	:	SPRINGDALE
State	:	AR
Zip	:	72762-0845
Country	:	US
Telephone Number	:	479-725-6800
Fax Number	:	479-725-6582

Provider Business Practice Location Address
First Line	:	2601 GENE GEORGE BLVD
Second Line	:
City	:	SPRINGDALE
State	:	AR
Zip	:	72762-0845
Country	:	US
Telephone Number	:	479-725-6800
Fax Number	:	479-725-6582

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/09/2006
Last Update Date	:	05/06/2026

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Directions to “ DR. DARWIN MARTIN KOLLER M.D.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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