Individual
DR. VICTOR A. ROZEBOOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
214 CARTER ST, BERRYVILLE, AR 72616-4303
(870) 423-3355
(870) 423-5233
Mailing address
PO BOX 2580, SPRINGFIELD, MO 65801-2580
(417) 829-4620
(417) 829-4316
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
R2954
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
54586
AR BLUE SHIELD #
AR
Enumeration date
07/19/2006
Last updated
07/09/2007
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