Provider Demographics
NPI:1659365120
Name:STOWERS, MARION MIDDLEKAMP (MD)
Entity Type:Individual
Prefix:DR
First Name:MARION
Middle Name:MIDDLEKAMP
Last Name:STOWERS
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 1:2 HEATHER OAKS WAY
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72830-2026
Mailing Address - Country:US
Mailing Address - Phone:479-705-0333
Mailing Address - Fax:479-754-4889
Practice Address - Street 1:2 HEATHER OAKS WAY
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:AR
Practice Address - Zip Code:72830-2026
Practice Address - Country:US
Practice Address - Phone:479-705-0333
Practice Address - Fax:479-754-4889
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-09
Last Update Date:2010-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE00652084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR131366001Medicaid
ARF80691Medicare UPIN
AR5J401Medicare ID - Type Unspecified