Individual
DR. MARK ALAN DYER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
10001 LILE DR, LITTLE ROCK, AR 72205-6217
(501) 227-8000
(501) 663-9665
Mailing address
10001 LILE DR, LITTLE ROCK, AR 72205-6217
(501) 227-8000
(501) 663-9665
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
E-4368
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
158423001
—
AR
01
—
5N245
MEDICARE
AR
01
—
686451
MEDICARE ID# FOR CHI ST. VINCENT LITTLE ROCK DIAGNOSTIC CLINIC
AR
Enumeration date
12/05/2006
Last updated
04/17/2019
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