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Individual

JUAN C ROMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
500 S UNIVERSITY AVE STE 214, LITTLE ROCK, AR 72205-5304
(501) 476-3914
Mailing address
500 S UNIVERSITY AVE STE 214, LITTLE ROCK, AR 72205-5304
(501) 476-3914

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
E-1764
AR
207LP2900X
Pain Medicine (Anesthesiology) Physician
E-1764
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
050060897
RAILROAD MEDICARE (LRPM)
AR
01
050060898
RAILROAD MEDICARE
AR
05
134483001
AR
01
171973300
US DEPT. OF LABOR OWCP
AR
01
172478000
US DOL OWCP (LRPM)
AR
01
1792000020
QUAL CHOICE (LRPM)
AR
01
5K805
BLUE CROSS BLUE SHIELD
AR
01
71033532430
QUAL CHOICE
AR
01
770132401
ARKANSAS BREASTCARE
AR
01
S01847
NOVASYS
AR
Enumeration date
09/27/2005
Last updated
09/14/2018
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