Provider Demographics
NPI:1932293743
Name:MAY, ROBERT HENRY (MDPA)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:HENRY
Last Name:MAY
Suffix:
Gender:M
Credentials:MDPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 MEDICINE DR
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72830-4431
Mailing Address - Country:US
Mailing Address - Phone:479-754-7405
Mailing Address - Fax:
Practice Address - Street 1:1 MEDICINE DR
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:AR
Practice Address - Zip Code:72830-4431
Practice Address - Country:US
Practice Address - Phone:479-754-5405
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2010-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARC4245207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR103905001Medicaid
AR53398Medicare PIN
AR103905001Medicaid