Individual
DR. CLARISSE TALLAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
201 SW 14TH ST, BENTONVILLE, AR 72712-7449
(479) 785-2229
(479) 314-3185
Mailing address
PO BOX 776084, CHICAGO, IL 60677-6084
(479) 785-2229
(479) 314-3185
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
2021030592
MO
207Q00000X
Family Medicine Physician
Primary
E-19686
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200101118
—
MO
Enumeration date
06/13/2016
Last updated
03/25/2026
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