Organization
HEART ASSOCIATES OF SOUTH ARKANSAS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALDO V FONTICIELLA MD (PRESIDENT)
(870) 866-9450
Entity
Organization
Contact information
Practice address
619 W GROVE ST, EL DORADO, AR 71730-4413
(870) 863-6133
(870) 863-6290
Mailing address
619 W GROVE ST, EL DORADO, AR 71730-4413
(870) 863-6133
(870) 863-6290
Taxonomy
Speciality
Code
Description
License number
State
207RI0011X
Interventional Cardiology Physician
Primary
E0097
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
125598001
—
AR
01
—
5C008
BCBS
AR
Enumeration date
11/21/2006
Last updated
04/10/2018
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