Provider Demographics
NPI:1568998235
Name:MINNIEAR-CORRONS, MEGAN (MD)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:MINNIEAR-CORRONS
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 1:2 MEDICINE DR
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72830-4431
Mailing Address - Country:US
Mailing Address - Phone:479-705-2124
Mailing Address - Fax:479-705-2129
Practice Address - Street 1:2 MEDICINE DR
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:AR
Practice Address - Zip Code:72830-4431
Practice Address - Country:US
Practice Address - Phone:479-705-2124
Practice Address - Fax:479-705-2129
Is Sole Proprietor?:No
Enumeration Date:2017-05-02
Last Update Date:2020-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE13122207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine