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Contact Information

DAVID M STREET, PA
2010 ACTIVE WAY
BENTON, AR72022-9267
 Phone: 501-315-0984
 Fax: 501-847-1405
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Surgical

363AS0400X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for DAVID M STREET · (Male)

NPI Number 1487252755
Status Active
Credentials PA (Physician Assistant)
Entity Individual
Enumeration date 10/09/2020
Last updated 10/09/2020 - About 6 years ago
Sole proprietor 1 No
Identifiers
  • AR License # PT2020058
  • AR Other PT2020-058 ARKANSAS STATE LICENSE
Hospital affiliation(s)
  • SALINE MEMORIAL HOSPITAL - (Acute Care)
    #1 MEDICAL PARK DRIVE
    BENTON, AR 72015
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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