Provider Demographics
NPI:1811174238
Name:MCGUIRE, SAM A III (MD)
Entity type:Individual
Prefix:DR
First Name:SAM
Middle Name:A
Last Name:MCGUIRE
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:SAMUEL
Other - Middle Name:A
Other - Last Name:MCGUIRE
Other - Suffix:III
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:245 MADISON ST
Mailing Address - Street 2:
Mailing Address - City:CLARENDON
Mailing Address - State:AR
Mailing Address - Zip Code:72029
Mailing Address - Country:US
Mailing Address - Phone:870-747-3381
Mailing Address - Fax:870-747-3631
Practice Address - Street 1:245 MADISON ST
Practice Address - Street 2:
Practice Address - City:CLARENDON
Practice Address - State:AR
Practice Address - Zip Code:72029-2706
Practice Address - Country:US
Practice Address - Phone:870-747-3381
Practice Address - Fax:870-747-3631
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-28
Last Update Date:2012-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARC-5222207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine