DR. MARY EVELYN BOURLAND MD NPI 1164480679

NPI Information

NPI: 1164480679
Provider Name: DR. MARY EVELYN BOURLAND, MD
Classification: Surgery - 2086S0129X
Entity Type: Individual

Specialization: Vascular Surgery

Address:
2708 RIFE MEDICAL LN
SUITE 210
ROGERS, AR
ZIP 72758
Phone: (479) 338-3888
Get Directions

DR. Mary Evelyn Bourland, MD is a vascular surgery surgery in Rogers, AR. The provider is a surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. DR. Mary Evelyn Bourland, MD NPI is 1164480679. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

2708 RIFE MEDICAL LN
SUITE 210
ROGERS, AR
ZIP 72758-452
Phone: (479) 338-3888
Fax: (479) 338-4453

The enumeration date for this NPI number is 5/3/2006 and was last updated on 5/3/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2086S0129X	Surgery	Vascular Surgery	E4355	ARKANSAS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	F58711	MEDICARE UPIN	ARKANSAS
2	122998001	MEDICAID	ARKANSAS
3	5N191	MEDICARE ID-TYPE UNSPECIFIED	ARKANSAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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