DR. MARY EVELYN BOURLAND (NPI# 1164480679) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164480679 |
| Entity Type | Individual |
| Full Name | DR. MARY EVELYN BOURLAND |
| Credential | MD |
| Practice Address |
2708 Rife Medical Ln Suite 210 Rogers AR 72758-1452 |
| Practice Telephone | 4793383888 |
| Practice Fax Number | 4793384453 |
| Mailing Telephone | 4793383888 |
| Mailing Fax Number | 4793384453 |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2008-05-03 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0129X |
Surgery Specialization: Vascular Surgery |
E4355 | AR | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AR | 122998001 | 05 |
| Street Address |
2708 RIFE MEDICAL LN SUITE 210 |
| City | ROGERS |
| State | AR |
| Zip Code | 72758-1452 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831171263 | Dimitry A. Fomin | Psychiatry & Neurology | 2708 Rife Medical Ln, Suite 200, Rogers, AR 72758-1452 | 2005-11-21 |
| 1538325931 | Mercy Clinic Springfield Communities | Physician Assistant | 2708 Rife Medical Ln, Suite 310, Rogers, AR 72758-1452 | 2008-08-05 |
| 1295926533 | Amer Raza | Internal Medicine | 2708 Rife Medical Ln, Suite 200, Rogers, AR 72758-1452 | 2007-08-01 |
| 1225161805 | Brenda G Rowe | Nurse Practitioner | 2708 Rife Medical Ln, Suite 210, Rogers, AR 72758-1452 | 2007-03-13 |
| 1770635047 | Larry W. Weathers | Internal Medicine | 2708 Rife Medical Ln, Suite 220, Rogers, AR 72758-1452 | 2007-01-17 |
| 1518039452 | Debra Ann Walker | Nurse Practitioner | 2708 Rife Medical Ln, Suite 220, Rogers, AR 72758-1452 | 2006-11-15 |
| 1427067867 | Matthew Glen Steed | Family Medicine | 2708 Rife Medical Ln, Ste 130, Rogers, AR 72758-1452 | 2006-08-05 |
| 1881626331 | Kimberly K Bruyere | Nurse Practitioner | 2708 Rife Medical Ln, Suite 210, Rogers, AR 72758-1452 | 2006-07-07 |
| 1861448789 | Donna Jayne Murdock | Nurse Practitioner | 2708 Rife Medical Ln, Suite 210, Rogers, AR 72758-1452 | 2006-05-25 |
| 1437104007 | Robert Thaxton Wells | Internal Medicine | 2708 Rife Medical Ln, Suite 300, Rogers, AR 72758-1452 | 2006-05-23 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417588690 | Premier Hospitalists of Nwa, Pllc | Hospitalist | 4313 S Pleasant Crossing Blvd, Rogers, AR 72758 | 2020-01-28 |
| 1447893235 | Kelsey Elizabeth Sutton | Speech-Language Pathologist | 2100 West Perry Rd, Rogers, AR 72758 | 2019-10-24 |
| 1447700299 | Shannon Kaima | Physician Assistant | 5900 W Stoney Brook Rd Apt 14207, Rogers, AR 72758 | 2016-10-05 |
| 1801345426 | The Exclusive Eye, Pllc | Optometrist | 5100 W Pauline Whitaker Parkway, 107, Rogers, AR 72758 | 2016-09-23 |
| 1780063909 | Nicholas Honea | Nurse Anesthetist, Certified Registered | 4600 Centre Court, Rogers, AR 72758 | 2015-05-20 |
| 1811388945 | Amanda M Hawes | Physician Assistant | 1000 S. 52nd Street, Rogers, AR 72758 | 2015-02-11 |
| 1316354087 | Natalie Horine | Chiropractor | 4305 S Pleasant Crossing Blvd Ste 102, Rogers, AR 72758 | 2014-07-15 |
| 1205248903 | Clyde K. Tempel | Registered Nurse | 2100 W. New Hope Rd. #1804, Rogers, AR 72758 | 2014-05-29 |
| 1548692445 | Becky Tadlock Ross | Pharmacist | 1766 West Laurel, Rogers, AR 72758 | 2013-08-01 |
| 1497190797 | Medical Associates of Northwest Arkansas Pa | Pediatrics | 3730 S Pinnacle Hills Pkwy Ste 3, Rogers, AR 72758 | 2013-05-01 |
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| Taxonomy Code | 2086S0129X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Vascular Surgery |
| A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235778515 | Arkansas Vascular Surgery, Pllc | Surgery | 11300 N Rodney Parham Rd Ste 210, Little Rock, AR 72212-4149 | 2020-01-03 |
| 1063741924 | Lon G. Bitzer, M.d., P.a. | Surgery | 1801 W 40th Ave Ste 4c, Pine Bluff, AR 71603-6961 | 2009-12-23 |
| 1346317476 | Arkansas Health Group | Surgery | 9601 Lile Dr Ste 250, Medical Towers 1, Little Rock, AR 72205-6355 | 2006-11-30 |
| 1760498554 | Edward C. Loebl | Surgery | 9601 Lile Drive, Suite 250, Little Rock, AR 72205-6321 | 2006-07-31 |
| 1962466748 | Donald L Patrick | Surgery | 305 Rodgers Dr, Searcy, AR 72143-7432 | 2006-04-17 |
| 1225416928 | Usa Vein Clinics of Little Rock, Pllc | Surgery | 609 Sw 8th St, Suite 600, Bentonville, AR 72712-7886 | 2015-05-13 |
| 1619234366 | Christian Dupre Simmons | Surgery | 4301 W Markham St # 520, Little Rock, AR 72205 | 2012-04-19 |
| 1386872695 | Jason Leonard Muesse | Surgery | 4301 W Markham St, Little Rock, AR 72205-7101 | 2009-06-24 |
| 1528220639 | Matthew Brewster Hendrich | Surgery | 201 E Oak Ave, Jonesboro, AR 72401-4163 | 2008-06-30 |
| 1437260577 | Cardiac and Vascular Surgeons Pa | Surgery | 9601 Lile Dr, Suite 650, Little Rock, AR 72205-6321 | 2006-08-31 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.