Individual
MIKEAL ROBERT LOVE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1100 N COLLEGE AVE, FAYETTEVILLE, AR 72703-1944
(479) 443-4301
Mailing address
174 E CYDNEE ST, FAYETTEVILLE, AR 72703-3987
(512) 773-9682
Taxonomy
Speciality
Code
Description
License number
State
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
Primary
E-13080
AR
207V00000X
Obstetrics & Gynecology Physician
H7322
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
TXB118821
MEDICARE PTAN
TX
Enumeration date
08/30/2005
Last updated
09/08/2025
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