Individual
DR. EARL W FEURTADO III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2302 COLLEGE AVE, CONWAY, AR 72034-6297
(501) 513-5793
Mailing address
2302 COLLEGE AVE, CONWAY, AR 72034-6297
(501) 513-5793
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
C5964
AR
207PE0005X
Undersea and Hyperbaric Medicine (Emergency Medicine) Physician
C5964
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103074001
—
AR
01
—
1154318152
BCBS
AR
Enumeration date
10/04/2005
Last updated
11/01/2010
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