Individual
DR. ANNETTE M ENDERLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
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 STE 300, BENTON, AR 72015-3726
(501) 778-1113
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
C7476
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0820031
UNITEDHEALTHCARE
AR
05
—
122419001
—
AR
01
—
13767000000
QUALCHOICE
AR
01
—
180034661
RAILROAD MEDICARE
AR
01
—
4570317
AETNA
AR
01
—
6891055002
CIGNA
AR
01
—
71081368572015A002
TRICARE
AR
Enumeration date
02/15/2006
Last updated
09/30/2013
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