Provider Demographics
NPI:1568437101
Name:PARTRIDGE, PAIGE M (MD)
Entity Type:Individual
Prefix:DR
First Name:PAIGE
Middle Name:M
Last Name:PARTRIDGE
Suffix:
Gender:F
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:PO BOX 523
Mailing Address - Street 2:
Mailing Address - City:JOHNSON
Mailing Address - State:AR
Mailing Address - Zip Code:72741-0523
Mailing Address - Country:US
Mailing Address - Phone:479-521-4433
Mailing Address - Fax:479-521-0444
Practice Address - Street 1:4301 GREATHOUSE SPRINGS RD
Practice Address - Street 2:SUITE 100
Practice Address - City:JOHNSON
Practice Address - State:AR
Practice Address - Zip Code:72741-0523
Practice Address - Country:US
Practice Address - Phone:479-521-4433
Practice Address - Fax:479-521-0444
Is Sole Proprietor?:No
Enumeration Date:2006-02-17
Last Update Date:2007-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE2514207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ARE2514OtherSTATE LICENSE
ARH21844Medicare UPIN
ARE2514OtherSTATE LICENSE