Organization
ROBERT PETRINO, MD, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LORI JUSTICE (CREDENTIALING OFFICER)
(539) 664-7190
Entity
Organization
Contact information
Practice address
706 QUANDT AVE, STE A, SPRINGDALE, AR 72764
(479) 757-2030
(479) 750-6236
Mailing address
PO BOX 343, SPRINGDALE, AR 72765-0343
(539) 664-7190
(479) 756-2721
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
C5439
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
214698002
—
AR
Enumeration date
03/16/2016
Last updated
04/22/2022
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