Individual
MS. SUSAN TATE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
3401 SPRINGHILL DR, SUITE 460, NORTH LITTLE ROCK, AR 72117-2924
(501) 945-1888
(501) 945-4102
Mailing address
109 NATALIE LN, JACKSONVILLE, AR 72076-9378
(501) 835-1069
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA-168
AR
Other
Enumeration date
08/05/2006
Last updated
07/08/2007
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