Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | 2872 | AR |
NPI | 1053532135 |
---|---|
Provider Name | Dr. Mark D. Helms |
First Address | Russellville, AR 72811-1104 |
Second Address | Russellville, AR 72801-2534 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/05/2007 |
Last Update Date | 08/07/2007 |