Dr. Mary Evelyn Bourland
Vascular Surgeon
2708 Rife Medical Ln Suite 210
Rogers
, Arkansas 72758-1452
Dr. Mary Evelyn Bourland
Vascular Surgeon
2708 Rife Medical Ln Suite 210
Rogers
, Arkansas 72758-1452
(479) 338-4453
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About
Features
Specialties
- Vascular Surgeon
Languages spoken
- English
Location
First Address
- Dr. Mary Evelyn Bourland
- 2708 Rife Medical Ln Suite 210
- Rogers, AR
- Zip : 72758-1452
- Fax : (479) 338-4453
- Phone : (479) 338-3888
Second Address
- Dr. Mary Evelyn Bourland
- 2708 Rife Medical Ln Suite 210
- Rogers, AR
- Zip : 72758-1452
- Fax : (479) 338-4453
- Phone : (479) 338-3888
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 2086S0129X | Vascular Surgeon | E4355 | AR |
National Provider Identifier
| NPI | 1164480679 |
|---|---|
| Provider Name | Dr. Mary Evelyn Bourland |
| First Address | Rogers, AR 72758-1452 |
| Second Address | Rogers, AR 72758-1452 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 03/05/2006 |
| Last Update Date | 03/05/2008 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 122998001 | (05) | AR |
| F58711 | (02) | AR |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.