Provider Demographics
NPI:1841589017
Name:VIEGAS, MARK GERARD (MD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:GERARD
Last Name:VIEGAS
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 1:1100 N UNIVERSITY AVE STE 1
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72207-6348
Mailing Address - Country:US
Mailing Address - Phone:501-664-2500
Mailing Address - Fax:
Practice Address - Street 1:1100 N UNIVERSITY AVE STE 1
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72207-6348
Practice Address - Country:US
Practice Address - Phone:501-664-2500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-28
Last Update Date:2015-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-8628207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine