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Individual

AMANDA G. CHISUM-PRICE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
923 LEXINGTON AVE, FORT SMITH, AR 72901-4943
(479) 709-7350
(479) 709-7355
Mailing address
PO BOX 402330, ATLANTA, GA 30384-2330
(479) 709-7399
(479) 709-7053

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
E-5310
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
166054001
AR
05
200117300A
OK
Enumeration date
08/06/2007
Last updated
03/28/2012
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