Individual
LENA ROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2909 MILITARY RD, BENTON, AR 72015-2721
(501) 315-6500
(501) 315-0006
Mailing address
2909 MILITARY RD, BENTON, AR 72015-2721
(501) 315-6500
(501) 315-0006
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
E3325
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5M725
BCBS
AR
Enumeration date
06/23/2006
Last updated
07/08/2007
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