Individual
MARY JOAN BURGESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4301 W MARKHAM ST # 783, LITTLE ROCK, AR 72205-7101
(501) 686-8000
(501) 526-5148
Mailing address
4301 W MARKHAM ST # 783, LITTLE ROCK, AR 72205-7101
(501) 686-8000
(501) 526-5148
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
E-8677
AR
207RI0200X
Infectious Disease Physician
Primary
E-8677
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
204615001
—
AR
01
—
P00970254
RAILROAD MEDICARE
MN
Enumeration date
07/24/2008
Last updated
08/20/2020
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