Provider Demographics
NPI:1356377741
Name:EKMAN, LINDA M (MD)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:M
Last Name:EKMAN
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:PO BOX 3531
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72702-3531
Mailing Address - Country:US
Mailing Address - Phone:479-521-0200
Mailing Address - Fax:479-521-4942
Practice Address - Street 1:117 E SYCAMORE ST
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72703-2540
Practice Address - Country:US
Practice Address - Phone:479-521-0200
Practice Address - Fax:479-521-4942
Is Sole Proprietor?:No
Enumeration Date:2006-06-25
Last Update Date:2011-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARN-7604208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR5K613OtherAR BC/BS
ARB90569Medicare UPIN