Provider Demographics
NPI:1669430682
Name:FLOWERS, MARTHA A (MD)
Entity type:Individual
Prefix:
First Name:MARTHA
Middle Name:A
Last Name:FLOWERS
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 1780
Mailing Address - Street 2:
Mailing Address - City:PINE BLUFF
Mailing Address - State:AR
Mailing Address - Zip Code:71613-1780
Mailing Address - Country:US
Mailing Address - Phone:870-534-5523
Mailing Address - Fax:
Practice Address - Street 1:1401 S STATE ST
Practice Address - Street 2:SUITE C
Practice Address - City:PINE BLUFF
Practice Address - State:AR
Practice Address - Zip Code:71601-5856
Practice Address - Country:US
Practice Address - Phone:870-534-5523
Practice Address - Fax:870-534-2186
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-01
Last Update Date:2012-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARARR2394207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR103169001Medicaid
AR51716Medicare ID - Type Unspecified
AR103169001Medicaid