Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208D00000X | General Practice Physician | E3777 | AR |
NPI | 1023070638 |
---|---|
Provider Name | Dr. David Wayne Furr |
First Address | Springdale, AR 72762-0876 |
Second Address | Springdale, AR 72762-0876 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/04/2006 |
Last Update Date | 29/06/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H67673 | (02) | AR |
H67673 | (02) | OK |