Individual
DR. TRAVIS EZELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
760 MICHAELA DR, NORTH LITTLE ROCK, AR 72117-5361
(501) 992-1006
Mailing address
1101 TROY DR, BENTON, AR 72019-1904
(870) 405-7041
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PD14976
AR
Other
Enumeration date
09/24/2020
Last updated
09/24/2020
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