Bourland, Mary Evelyn

Bourland, Mary Evelyn is an individual health care provider with primary practice located at 2708 Rife Medical Ln Suite 210, Rogers AR 72758-1452. She recently has only one registered license in Allopathic & Osteopathic Physicians / Vascular Surgery, which is considered as her primary health care specialty. Bourland, Mary Evelyn can be contacted via phone (479) 338-3888.

Contact Information

Primary practice address
2708 Rife Medical Ln Suite 210 Rogers AR 72758-1452
Phone: (479) 338-3888
Fax: (479) 338-4453
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Vascular Surgery 2086S0129X E4355 Arkansas

Profile Details

NPI number 1164480679
LBN Legal business name Bourland, Mary Evelyn
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 3rd, 2006
Last updated May 3rd, 2008 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1164480679 NPPES
Arkansas MEDICAID 122998001

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