Provider Demographics
NPI:1679878854
Name:JAMES D SHARP MD PLLC
Entity Type:Organization
Organization Name:JAMES D SHARP MD PLLC
Other - Org Name:JAMES D SHARP MD SOLE MBR
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:D
Authorized Official - Last Name:SHARP
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:479-419-9393
Mailing Address - Street 1:601 W MAPLE AVE
Mailing Address - Street 2:SUITE 205A
Mailing Address - City:SPRINGDALE
Mailing Address - State:AR
Mailing Address - Zip Code:72764-5335
Mailing Address - Country:US
Mailing Address - Phone:479-419-9393
Mailing Address - Fax:479-419-9513
Practice Address - Street 1:601 W MAPLE AVE
Practice Address - Street 2:SUITE 205A
Practice Address - City:SPRINGDALE
Practice Address - State:AR
Practice Address - Zip Code:72764-5335
Practice Address - Country:US
Practice Address - Phone:479-419-9393
Practice Address - Fax:479-419-9513
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-19
Last Update Date:2011-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARC-4526207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR106365001Medicaid
B76641Medicare UPIN