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Individual

MARY MARGARET MINSKY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
2918 LOUIS SESSIONS ST, LAKE VILLAGE, AR 71653-6049
(870) 265-5343
(870) 265-5686
Mailing address
2918 LOUIS SESSIONS ST, LAKE VILLAGE, AR 71653-6049
(870) 265-5343
(870) 265-5686

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
P-T1015
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1619286150
NPI
AR
05
191339795
AR
01
57428P278
BCBS AR
AR
01
P-T1015
STATE LICENSE
AR
Enumeration date
10/01/2010
Last updated
09/27/2024
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