Individual
MATTHEW SELF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
200 N 3RD ST, DARDANELLE, AR 72834-3802
(479) 229-2827
(479) 229-6167
Mailing address
24 LARKSPUR CT, RUSSELLVILLE, AR 72802-6913
(479) 967-3009
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
E-5282
AR
Other
Enumeration date
04/03/2007
Last updated
01/11/2008
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