Suffridge, Phillip J
Suffridge, Phillip J is an individual health care provider with primary practice located at 3 Medical Park Dr Suite 300, Benton AR 72015-3728. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Suffridge, Phillip J can be contacted via phone (501) 778-1113.Contact Information
Primary practice address
3 Medical Park Dr Suite 300
Benton AR 72015-3728
Phone: (501) 778-1113
Fax: (501) 778-5391
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Ophthalmology | 207W00000X | E2274 | Arkansas |
Profile Details
| NPI number | 1730142530 |
|---|---|
| LBN Legal business name | Suffridge, Phillip J |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 11th, 2006 |
| Last updated | Sep 30th, 2013 - about 12 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 | 1730142530 | NPPES |
| Arkansas | MEDICAID | 161592001 | |
| Arkansas | Other | 06040018300 | |
| Arkansas | Other | 5N525 | |
| Arkansas | Other | P00445226 | |
| Arkansas | Other | 204462170 |
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