Organization
SALINE MED-PEDS GROUP, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK A MARTINDALE M.D. (OWNER)
(501) 315-1222
Entity
Organization
Contact information
Practice address
105 MCNEIL ST, BENTON, AR 72015-3345
(501) 315-1222
(501) 315-1241
Mailing address
105 MCNEIL ST, BENTON, AR 72015-3345
(501) 315-1222
(501) 315-1222
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
C7310
AR
207R00000X
Internal Medicine Physician
—
—
208000000X
Pediatrics Physician
C7310
AR
208000000X
Pediatrics Physician
E5062
AR
208000000X
Pediatrics Physician
Primary
—
—
208D00000X
General Practice Physician
C2718
AR
208D00000X
General Practice Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
161473002
—
AR
Enumeration date
10/26/2006
Last updated
04/28/2023
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