Provider Demographics
NPI:1912576588
Name:CALHOUN, MATTHEW BEDFORD (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:BEDFORD
Last Name:CALHOUN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:218 E GRANADA ST
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72703-3360
Mailing Address - Country:US
Mailing Address - Phone:501-628-7215
Mailing Address - Fax:
Practice Address - Street 1:524 S SCHOOL AVE
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72701-5957
Practice Address - Country:US
Practice Address - Phone:479-251-7685
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-18
Last Update Date:2021-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPD15765183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist