Individual
DR. ALICE VIRGINIA FANN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D., PH.D.
Contact information
Practice address
2200 FORT ROOTS DR, RT 117/NLR, NORTH LITTLE ROCK, AR 72114-1709
(501) 257-2995
(501) 257-2993
Mailing address
2200 FORT ROOTS DR, RT 117/NLR, DEPT. OF PM&R, NORTH LITTLE ROCK, AR 72114-1709
(501) 257-2995
(501) 257-2993
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
E-0357
AR
Other
Enumeration date
09/29/2006
Last updated
07/08/2007
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