Provider Demographics
NPI:1043271364
Name:BARD, DAVID SAYRE (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:SAYRE
Last Name:BARD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9501 LILE DRIVE
Mailing Address - Street 2:STE 777
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-6232
Mailing Address - Country:US
Mailing Address - Phone:501-228-7779
Mailing Address - Fax:501-228-7877
Practice Address - Street 1:9501 LILE DRIVE
Practice Address - Street 2:STE 777
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-6232
Practice Address - Country:US
Practice Address - Phone:501-228-7779
Practice Address - Fax:501-228-7877
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ARC5467208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
50319Medicare ID - Type Unspecified
C67800Medicare UPIN