Provider Demographics
NPI:1003495268
Name:BLOOM, GEORGE BARNES II (MD)
Entity type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:BARNES
Last Name:BLOOM
Suffix:II
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 1:101 HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:MAGNOLIA
Mailing Address - State:AR
Mailing Address - Zip Code:71753-2415
Mailing Address - Country:US
Mailing Address - Phone:870-235-3000
Mailing Address - Fax:
Practice Address - Street 1:101 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:MAGNOLIA
Practice Address - State:AR
Practice Address - Zip Code:71753-2415
Practice Address - Country:US
Practice Address - Phone:870-235-3000
Practice Address - Fax:575-235-6696
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-05
Last Update Date:2024-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-18351207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine