Organization
ROBERT A. COUNCIL, JR., MD, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT A. COUNCIL JR. M.D. (OWNER)
(501) 776-5070
Entity
Organization
Contact information
Practice address
1 MEDICAL PARK DR, BENTON, AR 72015-3353
(501) 776-6901
(501) 776-6908
Mailing address
PO BOX 9150, PADUCAH, KY 42002-9150
(270) 744-9600
(270) 744-0834
Taxonomy
Speciality
Code
Description
License number
State
207PE0005X
Undersea and Hyperbaric Medicine (Emergency Medicine) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
E2086
ELECTRONIC SUBMITTER
AR
Enumeration date
04/16/2007
Last updated
09/23/2009
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