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:
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Health care specialties

SpecialtyCodeLicense #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 12 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1184676041 NPPES
Arkansas MEDICAID 129335001

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