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:
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Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
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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