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Individual

DARRELL R OVER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
4010 S MULBERRY ST, PINE BLUFF, AR 71603-7000
(870) 541-6008
(870) 541-3198
Mailing address
4010 S MULBERRY ST, PINE BLUFF, AR 71603-7000
(870) 541-6008
(870) 541-3198

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
E-1462
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
132760001
AR
01
18887000002
QUAL CHOICE
AR
01
5K560
MEDICARE
AR
01
G53750
UPIN
AR
Enumeration date
04/24/2006
Last updated
02/07/2013
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