Provider Demographics
NPI:1154934016
Name:MIKE S MCFARLAND MDPA
Entity type:Organization
Organization Name:MIKE S MCFARLAND MDPA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONTROLLER
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:OFFUTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:870-536-4100
Mailing Address - Street 1:3805 W 28TH AVE
Mailing Address - Street 2:
Mailing Address - City:PINE BLUFF
Mailing Address - State:AR
Mailing Address - Zip Code:71603-4774
Mailing Address - Country:US
Mailing Address - Phone:870-536-4100
Mailing Address - Fax:870-534-3982
Practice Address - Street 1:9800 BAPTIST HEALTH DR STE 301
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-6230
Practice Address - Country:US
Practice Address - Phone:501-225-4488
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MIKE S MCFARLAND MDPA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-08-28
Last Update Date:2020-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty