Individual
LIDIA TESHOME DEGEFA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1601 W 40TH AVE, PINE BLUFF, AR 71603-6069
(870) 541-6010
(870) 541-6009
Mailing address
212 SUNSET PL UNIT B, REDFIELD, AR 72132-8653
(901) 364-1627
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
18735
AR
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
03/21/2023
Last updated
01/12/2025
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