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Individual

SAMUEL W VALLERY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2212 MALVERN AVE, SUITE 8, HOT SPRINGS, AR 71901-8038
(501) 609-2300
(501) 609-2301
Mailing address
704 W GROVE ST STE 1, EL DORADO, AR 71730-4469
(870) 863-2368
(870) 875-6233

Taxonomy

Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
E0503
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
16278000001
QUALCHOICE
05
166792002
AR
01
5J718
BCBS
01
P00470953
RAILROAD MEDICARE PTAN
AR
Enumeration date
08/09/2005
Last updated
09/09/2020
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