Provider Demographics
NPI:1881680247
Name:DOUGLAS W. MARX. M.D., P.A.
Entity Type:Organization
Organization Name:DOUGLAS W. MARX. M.D., P.A.
Other - Org Name:SNEED EYE ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:MARX
Authorized Official - Suffix:SR
Authorized Official - Credentials:MD
Authorized Official - Phone:870-424-2020
Mailing Address - Street 1:140 HIGHWAY 201 N
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN HOME
Mailing Address - State:AR
Mailing Address - Zip Code:72653-3158
Mailing Address - Country:US
Mailing Address - Phone:870-424-2020
Mailing Address - Fax:870-425-4840
Practice Address - Street 1:140 HIGHWAY 201 N
Practice Address - Street 2:
Practice Address - City:MOUNTAIN HOME
Practice Address - State:AR
Practice Address - Zip Code:72653-3158
Practice Address - Country:US
Practice Address - Phone:870-424-2020
Practice Address - Fax:870-425-4840
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-21
Last Update Date:2010-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR121891722Medicaid
AR118175002Medicaid
CH6105OtherPALMETTO GBA - RAILROAD MEDICARE
AR118175002Medicaid
AR121891722Medicaid
CH6105OtherPALMETTO GBA - RAILROAD MEDICARE
56942Medicare PIN