Provider Demographics
NPI:1083834378
Name:SOPHIA MEYER FAMILY MEDICINE LLC
Entity type:Organization
Organization Name:SOPHIA MEYER FAMILY MEDICINE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:R
Authorized Official - Last Name:FLOYD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:479-474-5061
Mailing Address - Street 1:620 BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:VAN BUREN
Mailing Address - State:AR
Mailing Address - Zip Code:72956-5830
Mailing Address - Country:US
Mailing Address - Phone:479-474-5061
Mailing Address - Fax:479-922-2007
Practice Address - Street 1:620 BROADWAY ST
Practice Address - Street 2:
Practice Address - City:VAN BUREN
Practice Address - State:AR
Practice Address - Zip Code:72956-5830
Practice Address - Country:US
Practice Address - Phone:479-474-5061
Practice Address - Fax:479-922-2007
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-27
Last Update Date:2012-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty