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Individual

MR. MARK WAYNE GOUDEAU

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
RPH

Contact information

Practice address
220 S WEST AVE, EL DORADO, AR 71730-5934
(870) 863-7669
(870) 863-4045
Mailing address
220 S WEST AVE, EL DORADO, AR 71730-5934
(870) 863-7669
(870) 863-4045

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
14334
LA
183500000X
Pharmacist
Primary
PD09279
AR

Other

Enumeration date
04/14/2008
Last updated
04/14/2008
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