Individual
LARKUS PESNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1127 MAIN ST, VILONIA, AR 72173-9525
(501) 796-6740
(501) 796-6744
Mailing address
117 S 2ND ST, PO BOX 497, AUGUSTA, AR 72006-2309
(870) 347-2534
(870) 347-3492
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
C4135
AR
208D00000X
General Practice Physician
Primary
C-4135
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100081520A
—
OK
05
—
106481001
—
AR
01
—
770119701
ARKANSAS BREASTCARE
AR
Enumeration date
12/05/2005
Last updated
01/03/2018
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