Provider Demographics
NPI:1275509069
Name:KUMAR, SUDHIR (MD)
Entity Type:Individual
Prefix:DR
First Name:SUDHIR
Middle Name:
Last Name:KUMAR
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 1:1801 LINDAUER RD
Mailing Address - Street 2:
Mailing Address - City:FORREST CITY
Mailing Address - State:AR
Mailing Address - Zip Code:72335-2407
Mailing Address - Country:US
Mailing Address - Phone:870-633-5016
Mailing Address - Fax:870-633-6309
Practice Address - Street 1:1801 LINDAUER RD
Practice Address - Street 2:
Practice Address - City:FORREST CITY
Practice Address - State:AR
Practice Address - Zip Code:72335-2407
Practice Address - Country:US
Practice Address - Phone:870-633-5016
Practice Address - Fax:870-633-6309
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARR4521207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR123881001Medicaid
AR5J223Medicare ID - Type Unspecified
AR123881001Medicaid