Individual
KATE ROXALYN GAZENKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1 MEDICINE DR, CLARKSVILLE, AR 72830-4431
(479) 754-6510
(479) 754-5644
Mailing address
1010 W MAIN ST, CLARKSVILLE, AR 72830-3417
(479) 705-2310
(479) 705-2300
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
35.099672
OH
208600000X
Surgery Physician
Primary
E9331
AR
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
210971001
—
AR
Enumeration date
06/19/2007
Last updated
04/19/2021
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