Provider Demographics
NPI:1821806662
Name:MIKE S MCFARLAND MDPA
Entity type:Organization
Organization Name:MIKE S MCFARLAND MDPA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONTROLLER
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:OFFUTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:870-536-4100
Mailing Address - Street 1:10700 N RODNEY PARHAM RD STE C2
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72212-4159
Mailing Address - Country:US
Mailing Address - Phone:501-830-2020
Mailing Address - Fax:
Practice Address - Street 1:312 W PERSHING BLVD
Practice Address - Street 2:
Practice Address - City:NORTH LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72114-2224
Practice Address - Country:US
Practice Address - Phone:501-830-2020
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MIKE S MCFARLAND MDPA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-12-26
Last Update Date:2024-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center