| NPI | 1700058641 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN E DORMAN President 479-756-6161 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AR R1723) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: LA 02181R) |
| Enumeration Date | 2008-04-01 |
| Last Update Date | 2008-07-30 |