Organization
PHILLIP SUFFRIDGE,M.D.,P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PHILLIP SUFFRIDGE M.D. (PRESIDENT)
(501) 778-1113
Entity
Organization
Contact information
Practice address
3 MEDICAL PARK DR, SUITE 300, BENTON, AR 72015-3728
(501) 778-1113
(501) 778-5391
Mailing address
3 MEDICAL PARK DR, SUITE 300, BENTON, AR 72015-3728
(501) 778-1113
(501) 778-5391
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
06040018300
QUALCHOICE
AR
Enumeration date
02/12/2007
Last updated
08/22/2020
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