| NPI | 1174603435 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELA ROSE STYLES Owner 479-754-4333 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: AR C-8311) |
| Additional Taxonomies | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: AR C-8311) |
| 207ND0900X Dermatology, Dermatopathology (Licence: AR C-8311) | |
| 207NI0002X Dermatology, Clinical & Laboratory Dermatological Immunology (Licence: AR C-8311) | |
| 207NP0225X Dermatology, Pediatric Dermatology (Licence: AR C-8311) | |
| 207NS0135X Dermatology, Procedural Dermatology (Licence: AR C-8311) | |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2012-01-12 |