DOUGLAS PROVAZNIK

LITTLE ROCK, AR
NPI1851897516
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy2084P0800X Psychiatry & Neurology, Psychiatry
(Licence: AR  E-14627)
Additional Taxonomies390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date2018-04-02
Last Update Date2022-01-31
Business Address
Dr. DOUGLAS PROVAZNIK MD
4301 W MARKHAM ST # 589
LITTLE ROCK, AR 72205-7199
Phone number: 501-526-8148
Mailing Address
Dr. DOUGLAS PROVAZNIK MD
4301 W MARKHAM ST # 589
LITTLE ROCK, AR 72205-7199
Phone number: 501-526-8148