Individual
MARK L STILLWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6801 ROGERS AVE FL 5, FORT SMITH, AR 72903-4067
(479) 274-4100
(479) 274-4199
Mailing address
PO BOX 776084, CHICAGO, IL 60677-6084
(479) 284-4100
(314) 364-6321
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
N7411
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100123480A
—
AR
05
—
114655001
—
AR
Enumeration date
10/05/2005
Last updated
10/18/2024
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