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NPI Code Detail

MEDICARE: DR. DAVID ARTHUR DIFFINE MD

MEDICARE:  DR. DAVID ARTHUR DIFFINE  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
1207Q00000XFamily Medicine Physician2000148413MO
2207Q00000XFamily Medicine PhysicianE-3767AR

Other Identifiers

General Provider Information

NPI Number : 1679576631
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DAVID ARTHUR DIFFINE MD
Provider Business Mailing Address
First Line : 1100 MEDICAL DR
Second Line : SUITE C
City : BLYTHEVILLE
State : AR
Zip : 72315-1425
Country : US
Telephone Number : 870-824-2809
Fax Number : 870-762-0731
Provider Business Practice Location Address
First Line : 1100 MEDICAL DR
Second Line : SUITE C
City : BLYTHEVILLE
State : AR
Zip : 72315-1425
Country : US
Telephone Number : 870-824-2809
Fax Number : 870-762-0731
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/24/2005
Last Update Date : 02/07/2024

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Directions to “ DR. DAVID ARTHUR DIFFINE MD” Practice Location

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