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Individual

CONNIE DRAPCHO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
3215 N NORTHHILLS BLVD, FAYETTEVILLE, AR 72703-4424
(479) 463-7102
(479) 463-7864
Mailing address
3215 N NORTHHILLS BLVD, FAYETTEVILLE, AR 72703-4424
(479) 463-7102
(479) 463-7864

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
104587
MO
208M00000X
Hospitalist Physician
Primary
E-10128
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100025940A
OK
05
100150210E
KS
01
200158
BCBS
MO
05
206810517
MO
01
P00964932
RAIL ROAD MEDICARE
MO
Enumeration date
03/29/2006
Last updated
12/09/2016
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