Individual
MAHLON OGDEN MARIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M. D.
Contact information
Practice address
715 W SHERMAN AVE, SUITE G, HARRISON, AR 72601-2743
(870) 741-8247
(870) 741-3933
Mailing address
PO BOX 1597, HARRISON, AR 72602-1597
(870) 741-8247
(870) 741-3933
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
C4123
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101262001
—
AR
Enumeration date
02/23/2006
Last updated
12/01/2009
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