Provider Demographics
NPI:1497756076
Name:ESPINA, DARIO M (MD, FACC)
Entity Type:Individual
Prefix:
First Name:DARIO
Middle Name:M
Last Name:ESPINA
Suffix:
Gender:M
Credentials:MD, FACC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 11768
Mailing Address - Street 2:
Mailing Address - City:FORT SMITH
Mailing Address - State:AR
Mailing Address - Zip Code:72917-1768
Mailing Address - Country:US
Mailing Address - Phone:479-484-1010
Mailing Address - Fax:479-785-9916
Practice Address - Street 1:205 E RAY FINE BLVD STE 6
Practice Address - Street 2:
Practice Address - City:ROLAND
Practice Address - State:OK
Practice Address - Zip Code:74954-5381
Practice Address - Country:US
Practice Address - Phone:918-503-6235
Practice Address - Fax:918-503-6239
Is Sole Proprietor?:No
Enumeration Date:2005-08-09
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK14997207RI0011X
ARE1954174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR136409001Medicaid
ARD50918Medicare UPIN
AR5L101Medicare PIN