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Organization

UNIVERSITY OF ARKANSAS FOR MEDICAL SCIENCE SOUTH

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. EDILBERTO DIZON ATIENZA JR. M.D. (FAMILY MEDICINE RESIDENT)
(240) 462-7236
Entity
Organization

Contact information

Practice address
1617 N WASHINGTON, MAGNOLIA, AR 71753-2046
(240) 462-7236
Mailing address
1725 ALLERFORD DR, HANOVER, MD 21076-1798
(240) 462-7236

Taxonomy

Speciality
Code
Description
License number
State
282NR1301X
Rural Acute Care Hospital
Primary

Other

Enumeration date
04/13/2015
Last updated
04/13/2015
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