Provider Demographics
NPI:1871790113
Name:PERNA, MARK JOHN (MD)
Entity type:Individual
Prefix:DR
First Name:MARK
Middle Name:JOHN
Last Name:PERNA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1101 S HORSEBARN RD
Mailing Address - Street 2:
Mailing Address - City:ROGERS
Mailing Address - State:AR
Mailing Address - Zip Code:72758-8237
Mailing Address - Country:US
Mailing Address - Phone:479-273-7700
Mailing Address - Fax:479-464-7734
Practice Address - Street 1:1101 S HORSEBARN RD
Practice Address - Street 2:
Practice Address - City:ROGERS
Practice Address - State:AR
Practice Address - Zip Code:72758-8237
Practice Address - Country:US
Practice Address - Phone:479-273-7700
Practice Address - Fax:479-464-7734
Is Sole Proprietor?:No
Enumeration Date:2007-06-29
Last Update Date:2016-09-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
ARE-9076208600000X, 207RB0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No207RB0002XAllopathic & Osteopathic PhysiciansInternal MedicineObesity Medicine