Individual
TIMOTHY MCCOWAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4301 W MARKHAM ST # 783, LITTLE ROCK, AR 72205-7101
(501) 686-8000
Mailing address
2500 NORTH STATE STREET, JACKSON, MS 39216
(601) 984-2538
(601) 815-1854
Taxonomy
Speciality
Code
Description
License number
State
2085R0204X
Vascular & Interventional Radiology Physician
Primary
19869
MS
2085R0204X
Vascular & Interventional Radiology Physician
C-5990
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110087001
—
AR
Enumeration date
09/27/2006
Last updated
03/12/2014
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