Basic Information
| Provider Information | |||||||||
| NPI: | 1154676344 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MCFARLAND | ||||||||
| FirstName: | MICHAEL | ||||||||
| MiddleName: | EDWARD | ||||||||
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| Credential: | PT, DPT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1800 SE MOBERLY LN STE 6 | ||||||||
| Address2: | |||||||||
| City: | BENTONVILLE | ||||||||
| State: | AR | ||||||||
| PostalCode: | 727127017 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4797156330 | ||||||||
| FaxNumber: | 4792685144 | ||||||||
| Practice Location | |||||||||
| Address1: | 1800 SE MOBERLY LN STE 6 | ||||||||
| Address2: | |||||||||
| City: | BENTONVILLE | ||||||||
| State: | AR | ||||||||
| PostalCode: | 727127017 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4797156330 | ||||||||
| FaxNumber: | 4792685144 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/13/2012 | ||||||||
| LastUpdateDate: | 05/02/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/02/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 2305207450 | VA | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | 225100000X | 5106 | AR | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | 225100000X | PT5106 | AR | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
ID Information
| ID | Type | State | Issuer | Description | P01232661 | 01 | VA | MEDICARE RR PTAN | OTHER | 1154676344 | 05 | VA | MEDICAID | C05954 | 01 | VA | GROUP MEDICARE PTAN | OTHER |