Individual
DALAL FARID JACOB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1224 CHEROKEE DR, NEWPORT, AR 72112-9998
(870) 523-5360
Mailing address
1224 CHEROKEE DR, NEWPORT, AR 72112-9998
(870) 523-5360
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
R-3150
AR
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
R-3150
AR
282NR1301X
Rural Acute Care Hospital
R-3150
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R-3150
ARKANSAS STATE MEDICAL LICENSE
AR
Enumeration date
07/16/2012
Last updated
07/16/2012
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