Individual
DR. MARK EDGAR MILLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2630 E CITIZENS DR, SUITE 3, FAYETTEVILLE, AR 72703-4797
(479) 527-9966
(479) 527-9677
Mailing address
2630 E CITIZENS DR, SUITE 3, FAYETTEVILLE, AR 72703-4797
(479) 527-9966
(479) 527-9677
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
C-8455
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
129335001
—
AR
Enumeration date
05/17/2006
Last updated
09/03/2014
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