Moulton, Michael Lowell
Moulton, Michael Lowell is an individual health care provider with primary practice located at 813 Founders Park Dr E , Springdale AR 72762-6314. He recently has only one registered license in Allopathic & Osteopathic Physicians / Nephrology, which is considered as his primary health care specialty. Moulton, Michael Lowell can be contacted via phone (479) 463-2440.Contact Information
Primary practice address
813 Founders Park Dr E
Springdale AR 72762-6314
Phone: (479) 463-2440
Fax: (479) 463-2465
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Nephrology | 207RN0300X | E-4391 | Arkansas |
Profile Details
| NPI number | 1558397489 |
|---|---|
| LBN Legal business name | Moulton, Michael Lowell |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 23rd, 2006 |
| Last updated | Nov 6th, 2013 - about 13 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 | 1558397489 | NPPES |
| Arkansas | Other | 5N139 | AR BC/BS |
| Arkansas | MEDICAID | 200054700A | AR BC/BS |
| Arkansas | MEDICAID | 156776001 | AR BC/BS |
| Arkansas | Other | P00219962 | AR BC/BS |
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