Individual
VICTOR L MANDOFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4301 W MARKHAM ST, UAMS SLOT 515, LITTLE ROCK, AR 72205-7101
(501) 686-7918
(501) 686-8139
Mailing address
4301 W MARKHAM ST, UAMS SLOT 515, LITTLE ROCK, AR 72205-7101
(501) 686-7918
(501) 686-8139
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
E-4786
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
06070017500
QUALCHOICE
AR
01
—
5N541
BCBS
AR
01
—
E4786
TRICARE
AR
01
—
P00350684
RAILROAD MEDICARE
AR
Enumeration date
09/22/2006
Last updated
01/08/2008
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