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1780793786
PAUL EDWARD PROVAZNIK
FAYETTEVILLE, AR
NPI
1780793786
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207R00000X Internal Medicine
(Licence: MI 4301057388)
Enumeration Date
2006-08-30
Last Update Date
2007-07-08
Business Address
Dr. PAUL EDWARD PROVAZNIK M.D.
1100 N COLLEGE AVE
FAYETTEVILLE, AR 72703-1944
Phone number: 479-444-5016
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Mailing Address
Dr. PAUL EDWARD PROVAZNIK M.D.
1100 N COLLEGE AVE
FAYETTEVILLE, AR 72703-1944
Phone number: 479-444-5016
Copy
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