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Individual

DR. RALPH CHRISTOPHER PANEK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3215 N NORTHHILLS BLVD, DEPARTMENT OF RADIOLOGY, FAYETTEVILLE, AR 72703-4424
(501) 291-1499
Mailing address
3215 N NORTHHILLS BLVD, DEPARTMENT OF RADIOLOGY, FAYETTEVILLE, AR 72703-4424
(501) 291-1499

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
E3928
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
164704001
AR
01
P00398630
RAILROAD MEDICARE
AR
Enumeration date
04/23/2007
Last updated
07/08/2010
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