MISS MARIELIE HEIDI AGESILAS (NPI# 1073809158) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073809158 |
| Entity Type | Individual |
| Full Name | MISS MARIELIE HEIDI AGESILAS |
| Credential | M.D. |
| Practice Address |
1125 N College Ave Fayetteville AR 72703-1908 |
| Mailing Address |
601 W. Maple Ste 102 Springdale AR 72764 |
| Practice Telephone | 4795218260 |
| Mailing Telephone | 4797506585 |
| Mailing Fax Number | 4798720040 |
| Enumeration Date | 2011-06-27 |
| Last Update Date | 2015-06-05 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | E-8365 | AR | Allopathic & Osteopathic Physicians |
| Street Address |
1125 N COLLEGE AVE |
| City | FAYETTEVILLE |
| State | AR |
| Zip Code | 72703-1908 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063407138 | Washington Regional Medical Center | Psychiatric Unit | 1125 N College Ave, Fayetteville, AR 72703-1908 | 2005-09-15 |
| 1982219663 | Sharon Reece | Family Medicine | 1125 N College Ave, Fayetteville, AR 72703-1908 | 2020-09-10 |
| 1841829249 | Raad J Abbas | Student in an Organized Health Care Education/Training Program | 1125 N College Ave, Fayetteville, AR 72703-1908 | 2020-04-07 |
| 1356978142 | Ijanae Holman-allgood | Student in an Organized Health Care Education/Training Program | 1125 N College Ave, Fayetteville, AR 72703-1908 | 2020-03-24 |
| 1114553096 | Joshua Daniel Johnson | Student in an Organized Health Care Education/Training Program | 1125 N College Ave, Fayetteville, AR 72703-1908 | 2020-03-23 |
| 1528694544 | Jovan Collantes Baker | Student in an Organized Health Care Education/Training Program | 1125 N College Ave, Fayetteville, AR 72703-1908 | 2020-03-21 |
| 1326674458 | Rachel Frances Mauldin | Student in an Organized Health Care Education/Training Program | 1125 N College Ave, Fayetteville, AR 72703-1908 | 2020-03-20 |
| 1922634039 | Kristian Ashtin De Nagel | Student in an Organized Health Care Education/Training Program | 1125 N College Ave, Fayetteville, AR 72703-1908 | 2020-03-20 |
| 1639705775 | Jacqueline L Thorpy | Student in an Organized Health Care Education/Training Program | 1125 N College Ave, Fayetteville, AR 72703-1908 | 2020-03-20 |
| 1003442153 | Alan Michael Zeto Jr. | Student in an Organized Health Care Education/Training Program | 1125 N College Ave, Fayetteville, AR 72703-1908 | 2020-03-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477154391 | Margaret Sorrells | Pharmacist | 3909 N Mall Ave Attn:pharmacy, Fayetteville, AR 72703 | 2020-11-06 |
| 1497369631 | Justin A Rand | Massage Therapist | 88 W Colt Square Dr, Fayetteville, Ar 72703, Fayetteville, AR 72703 | 2020-09-04 |
| 1235777558 | Washington Regional Medical System | Specialist | 3264 N North Hills Blvd, Fayetteville, AR 72703 | 2019-12-17 |
| 1760024582 | Haley Brooke Thompson | Occupational Therapist | 2474 E Joyce Blvd Ste 2, Null, Fayetteville, AR 72703 | 2019-10-14 |
| 1306492129 | Bhg L, LLC | Clinic/Center | 8 Colt Square Drive, Fayetteville, AR 72703 | 2019-08-16 |
| 1306406269 | Idell Marie Mitchell | Optometrist | Eye Clinic, 1100 N College Ave, Fayetteville, AR 72703 | 2019-06-13 |
| 1821574815 | Toni Myer | Nurse Practitioner | 3 E Appleby Rd Ste 101, Fayetteville, AR 72703 | 2018-07-13 |
| 1306340393 | Josh Kelfer | Student in an Organized Health Care Education/Training Program | 1125 North College Avenue, Fayetteville, AR 72703 | 2018-03-22 |
| 1649726449 | Vantage Point of Nwa | Community/Behavioral Health | 4171 N. Crossover Rd, Fayetteville, AR 72703 | 2016-08-31 |
| 1386097137 | Jason Nordstrom | Speech-Language Pathologist | 2664 N Valencia Ave, Fayetteville, AR 72703 | 2016-07-18 |
| Find all providers in zip 72703 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376169185 | Raheem Lalani | Family Medicine | 230 Fieldstone Way, Fayetteville, GA 30215-8170 | 2020-06-18 |
| 1821619370 | Kelly R. Mccarty | Family Medicine | 5872 W Bannister Dr, Fayetteville, AR 72704-6536 | 2020-05-06 |
| 1720620230 | Vector Health and Wellness, LLC | Family Medicine | 1267 N Steamboat Dr Ste 3, Fayetteville, AR 72704-7148 | 2019-10-16 |
| 1295382182 | Nimota Motunrayo Akintoye | Family Medicine | 140 Briergate Pl, Fayetteville, GA 30214-3931 | 2019-08-24 |
| 1609332725 | Fastmed Health Nc, Pllc | Family Medicine | 150 Francam Dr, Fayetteville, NC 28311-4500 | 2019-02-13 |
| 1013486638 | K E Management Services | Family Medicine | 1420 E Augustine Ln Ste 7, Fayetteville, AR 72703-4995 | 2018-11-14 |
| 1659896751 | Melissa Holt | Family Medicine | 108 Medical Center Blvd Ste G-50, Fayetteville, TN 37334-2741 | 2017-08-09 |
| 1124477484 | Mark William Guelzow | Family Medicine | 4101 Medical Center Dr Ste 1c, Fayetteville, NY 13066-6600 | 2016-06-08 |
| 1962865659 | Tracie Fullove | Family Medicine | 3162 W Martin Luther King Blvd Ste 13-14, Fayetteville, AR 72704-7679 | 2016-03-31 |
| 1053778936 | Linda Nancy Robinson | Family Medicine | 7107 Thorntree Hill Dr, Fayetteville, NY 13066-9790 | 2016-01-22 |
| Find all providers in FAYETTEVILLE | ||||
| City | FAYETTEVILLE |
| Zip Code | 72703 |
Please comment or provide details below to improve the information on MISS MARIELIE HEIDI AGESILAS.
| 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.