Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0000X | Obstetrician | N-7231 | AR |
NPI | 1073575148 |
---|---|
Provider Name | Mark Stripling |
First Address | Jonesboro, AR 72403-1960 |
Second Address | Jonesboro, AR 72401-8413 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/04/2006 |
Last Update Date | 18/03/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
113537001 | (05) | AR |
B90155 | (02) | AR |