Individual
DR. MARK BALTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2707 BROWNS LN, JONESBORO, AR 72401-7213
(870) 972-4939
(870) 972-4911
Mailing address
PO BOX 6430, SPRINGDALE, AR 72766-6430
(479) 750-2020
(479) 872-2441
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
C-6368
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
111552001
—
AR
01
—
5O262
BLUECROSS PROVIDER NUMBER
AR
Enumeration date
06/29/2006
Last updated
05/03/2010
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