Provider Demographics
NPI:1184612103
Name:STEARNS, DAVID E (MD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:E
Last Name:STEARNS
Suffix:
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 1:3560 JAMES CT
Mailing Address - Street 2:
Mailing Address - City:CONWAY
Mailing Address - State:AR
Mailing Address - Zip Code:72034-5578
Mailing Address - Country:US
Mailing Address - Phone:501-336-8772
Mailing Address - Fax:501-336-8772
Practice Address - Street 1:3560 JAMES CT
Practice Address - Street 2:
Practice Address - City:CONWAY
Practice Address - State:AR
Practice Address - Zip Code:72034-5578
Practice Address - Country:US
Practice Address - Phone:501-336-8772
Practice Address - Fax:501-336-8772
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-12
Last Update Date:2011-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARR3246208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR55104OtherBCBS
AR105956002Medicaid
AR55104OtherBCBS
AR55104Medicare ID - Type Unspecified