NPI 1467629469

Ccent & Fps

Organisation Allergy & Immunology Physician Lakeside, AR

Practice location

Address: 300 W White Mountain Blvd Suite D, Lakeside, AR 85929-6533
Phone: (928) 774-1873
Mailing address: 1340 N Rim Drive, Flagstaff, AZ 86001-1311

Authorised official

Name: Tamarah a Fratianni
Title: Physician
Phone: (928) 774-1873

Registered specialties (2)

Allergy & Immunology Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207K00000X Licence 3000 (AZ)

Other Allergy & Immunology providers in Arkansas →

Otolaryngology/Facial Plastic Surgery Physician

Allopathic & Osteopathic Physicians Taxonomy 207YX0905X Licence 3000 (AZ)

Other Otolaryngology providers in Arkansas →

Registry record

NPI: 1467629469
Entity type: Organization
NPI issued: 9 May 2008
Record last updated: 9 May 2008

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.