Miller, Mark Edgar
Miller, Mark Edgar is an sole proprietor health care provider with primary practice located at 2630 E Citizens Dr Suite 3, Fayetteville AR 72703-4797. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Miller, Mark Edgar can be contacted via phone (479) 527-9966.Contact Information
Primary practice address
2630 E Citizens Dr Suite 3
Fayetteville AR 72703-4797
Phone: (479) 527-9966
Fax: (479) 527-9677
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | C-8455 | Arkansas |
Profile Details
| NPI number | 1184676041 |
|---|---|
| LBN Legal business name | Miller, Mark Edgar |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 17th, 2006 |
| Last updated | Sep 3rd, 2014 - about 11 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 | 1184676041 | NPPES |
| Arkansas | MEDICAID | 129335001 |
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