Individual
MARVIN BRUCE SANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
500 S UNIVERSITY AVE STE 701, LITTLE ROCK, AR 72205-5309
(501) 664-5119
(501) 664-4209
Mailing address
500 S UNIVERSITY AVE STE 701, LITTLE ROCK, AR 72205-5309
(501) 664-5119
(501) 664-4209
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
C4641
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104566001
—
AR
Enumeration date
03/24/2006
Last updated
04/21/2020
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