Individual
DR. MARY EVELYN BOURLAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2708 RIFE MEDICAL LN, SUITE 210, ROGERS, AR 72758-1452
(479) 338-3888
(479) 338-4453
Mailing address
2708 RIFE MEDICAL LN, SUITE 210, ROGERS, AR 72758-1452
(479) 338-3888
(479) 338-4453
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
E4355
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
122998001
—
AR
Enumeration date
05/03/2006
Last updated
05/03/2008
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