Organization
MKOSMO, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MALIK SHAHID (OWNER)
(786) 623-8293
Entity
Organization
Contact information
Practice address
9524 WEY BRIDGE DR, FORT SMITH, AR 72916-7007
(786) 623-8293
Mailing address
9524 WEY BRIDGE DR, FORT SMITH, AR 72916-7007
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
08/25/2020
Last updated
08/25/2020
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