Provider Demographics
NPI:1912945528
Name:COWHERD, ROBERT MAC (MD/PHD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:MAC
Last Name:COWHERD
Suffix:
Gender:M
Credentials:MD/PHD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 1678
Mailing Address - Street 2:
Mailing Address - City:HEBER SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:72543-1678
Mailing Address - Country:US
Mailing Address - Phone:501-362-0500
Mailing Address - Fax:501-362-0501
Practice Address - Street 1:20 BAPTIST HEALTH DR
Practice Address - Street 2:
Practice Address - City:HEBER SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:72543-8765
Practice Address - Country:US
Practice Address - Phone:501-362-0500
Practice Address - Fax:501-362-0501
Is Sole Proprietor?:No
Enumeration Date:2006-06-04
Last Update Date:2016-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE3104207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR5M087OtherBCBS NUMBER
AR146104001Medicaid
AR7204399OtherAETNA NUMBER
AR9076374002OtherCIGNA NUMBER
AR731667341-72543-A003OtherTRICARE NUMBER
AR03110011900OtherQUALCHOICE NUMBER
ARP00091289OtherRAILROAD MEDICARE NUMBER
AR731667341-72543-A003OtherTRICARE NUMBER
AR03110011900OtherQUALCHOICE NUMBER