Individual
DAC TAT PHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
208 S MAIN AVE, BRINKLEY, AR 72021-3210
(870) 734-3222
(870) 734-1341
Mailing address
208 S MAIN AVE, BRINKLEY, AR 72021-3210
(870) 734-3222
(870) 734-1341
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
R3398
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103572001
—
AR
Enumeration date
09/29/2005
Last updated
04/04/2012
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