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Individual

DR. ROBERT B TROVILLION

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.P.M.

Contact information

Practice address
350 E MILLSAP RD, FAYETTEVILLE, AR 72703-4098
(479) 521-7850
(479) 442-4779
Mailing address
2783 N CENTERWOOD RD, FAYETTEVILLE, AR 72703-3604
(479) 251-1697
(479) 251-1691

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
000805
MO
213E00000X
Podiatrist
Primary
174
AR
213E00000X
Podiatrist
768
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1300660001
DME SUPPLIER NUMBER
05
135297717
AR
05
303841100
MO
01
480027223
RAILROAD RETIREMENT MEDIC
MO
01
480028754
RAILROAD RETIREMENT MEDIC
AR
Enumeration date
01/11/2007
Last updated
07/08/2007
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