Powell, Mark Wilson
Powell, Mark Wilson is an sole proprietor health care provider with primary practice located at 3733 N Business Dr Suite 102, Fayetteville AR 72703-5203. He recently has only one registered license in Allopathic & Osteopathic Physicians / Orthopaedic Surgery, which is considered as his primary health care specialty. Powell, Mark Wilson can be contacted via phone (479) 582-4647.Contact Information
Primary practice address
3733 N Business Dr Suite 102
Fayetteville AR 72703-5203
Phone: (479) 582-4647
Fax: (479) 582-4660
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Orthopaedic Surgery | 207X00000X | E1304 | Arkansas |
Profile Details
NPI number | 1992762629 |
---|---|
LBN Legal business name | Powell, Mark Wilson |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | Yes |
Enumeration date | Apr 27th, 2006 |
Last updated | Sep 4th, 2009 - 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1992762629 | NPPES |
Arkansas | MEDICAID | 132239001 |
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