Provider Demographics
NPI:1184121220
Name:CALCAGNI, MIKAILA NOEL WILSON (MD)
Entity type:Individual
Prefix:
First Name:MIKAILA
Middle Name:NOEL WILSON
Last Name:CALCAGNI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MISS
Other - First Name:MIKAILA
Other - Middle Name:N
Other - Last Name:WILSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:12714 ARBOR ACRES RD
Mailing Address - Street 2:
Mailing Address - City:SPRINGDALE
Mailing Address - State:AR
Mailing Address - Zip Code:72762-0986
Mailing Address - Country:US
Mailing Address - Phone:479-595-9550
Mailing Address - Fax:
Practice Address - Street 1:3901 PARKWAY CIR
Practice Address - Street 2:
Practice Address - City:SPRINGDALE
Practice Address - State:AR
Practice Address - Zip Code:72762-6362
Practice Address - Country:US
Practice Address - Phone:479-587-1700
Practice Address - Fax:479-587-1366
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-06
Last Update Date:2023-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-13818207R00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine