Individual
DR. JOSE ALBERT ANG FONTANILLA JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4077 ELM SPRINGS RD STE 105, SPRINGDALE, AR 72762-3703
(479) 927-2100
(479) 927-2211
Mailing address
2422 N THOMPSON SUITE A, SPRINGDALE, AR 72764
(479) 750-6566
(479) 750-5251
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
E3107
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
146213001
—
AR
Enumeration date
04/28/2006
Last updated
09/09/2020
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