Provider Demographics
NPI:1821068123
Name:EMERSON, STEVEN L (MD)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:L
Last Name:EMERSON
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 1:800 S CHURCH ST
Mailing Address - Street 2:SUITE 302
Mailing Address - City:JONESBORO
Mailing Address - State:AR
Mailing Address - Zip Code:72401-4176
Mailing Address - Country:US
Mailing Address - Phone:870-935-3990
Mailing Address - Fax:870-935-0871
Practice Address - Street 1:800 S CHURCH ST
Practice Address - Street 2:SUITE 302
Practice Address - City:JONESBORO
Practice Address - State:AR
Practice Address - Zip Code:72401-4176
Practice Address - Country:US
Practice Address - Phone:870-935-3990
Practice Address - Fax:870-935-0871
Is Sole Proprietor?:No
Enumeration Date:2006-01-26
Last Update Date:2012-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARC6138207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR12877000040OtherQUALCHOICE
AR770138301OtherEDS BREASTCARE
AR110424001Medicaid
AR160029430OtherMEDICARE RAILROAD CARRIER
AR51581OtherBLUE CROSS
AS0140033OtherHUMANA TRICARE
5367128OtherCIGNA
AR51581OtherBLUE CROSS
AR110424001Medicaid