Organization
VALACH NEPHROLOGY, HYPERTENSION AND INTERNAL MEDICINE, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL PESEK VALACH M.D. (NEPHROLOGIST)
(870) 508-5010
Entity
Organization
Contact information
Practice address
1409 HIGHWAY 201 N, SUITE 1, MOUNTAIN HOME, AR 72653-2425
(870) 508-5010
(870) 508-5020
Mailing address
1409 HIGHWAY 201 N, SUITE 1, MOUNTAIN HOME, AR 72653-2425
(870) 508-5010
(870) 508-5020
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
16660
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
149116002
—
AR
01
—
5C747
ARKANSAS BLUE CROSS BLUE SHIELD
AR
Enumeration date
07/22/2005
Last updated
07/03/2013
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