Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223S0112X | Oral and Maxillofacial Surgeon | 4232 | AR |
Y | 204E00000X | Oral & Maxillofacial Surgeon | 4232 | AR |
NPI | 1326345323 |
---|---|
Provider Name | Dr. Patton Mark Minkin |
First Address | Springdale, AR 72762-7726 |
Second Address | Springdale, AR 72762-7726 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/02/2011 |
Last Update Date | 19/01/2022 |