Individual
MR. MICHAEL ANDY JUSTUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2900 HAWKINS DR, SEARCY, AR 72143-4802
(501) 278-2800
Mailing address
2900 HAWKINS DR, SEARCY, AR 72143-4802
(501) 278-2800
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA0000001589
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1081760
NCCPA
—
Enumeration date
03/20/2008
Last updated
02/13/2015
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