Provider Demographics
NPI:1255318093
Name:ANDREWS-PIRTLE, VALENCIA MARIE (MD)
Entity type:Individual
Prefix:
First Name:VALENCIA
Middle Name:MARIE
Last Name:ANDREWS-PIRTLE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:605 N 2ND ST
Mailing Address - Street 2:
Mailing Address - City:BLYTHEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72315-2034
Mailing Address - Country:US
Mailing Address - Phone:870-532-6001
Mailing Address - Fax:870-532-6008
Practice Address - Street 1:605 N 2ND ST
Practice Address - Street 2:
Practice Address - City:BLYTHEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72315-2034
Practice Address - Country:US
Practice Address - Phone:870-532-6001
Practice Address - Fax:870-532-6008
Is Sole Proprietor?:No
Enumeration Date:2005-12-22
Last Update Date:2021-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE3358207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR146885001Medicaid
AR5M285Medicare PIN
AR146885001Medicaid