Bourland, Mary Evelyn
Bourland, Mary Evelyn is an individual health care provider with primary practice located at 2708 Rife Medical Ln Suite 210, Rogers AR 72758-1452. She recently has only one registered license in Allopathic & Osteopathic Physicians / Vascular Surgery, which is considered as her primary health care specialty. Bourland, Mary Evelyn can be contacted via phone (479) 338-3888.Contact Information
Primary practice address
2708 Rife Medical Ln Suite 210
Rogers AR 72758-1452
Phone: (479) 338-3888
Fax: (479) 338-4453
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Vascular Surgery | 2086S0129X | E4355 | Arkansas |
Profile Details
| NPI number | 1164480679 |
|---|---|
| LBN Legal business name | Bourland, Mary Evelyn |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 3rd, 2006 |
| Last updated | May 3rd, 2008 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1164480679 | NPPES |
| Arkansas | MEDICAID | 122998001 |
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