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Individual

DR. MOHSEN KEYASHIAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
6801 ROGERS AVE, FORT SMITH, AR 72903-4067
(479) 274-4100
(479) 274-4199
Mailing address
PO BOX 3528, FORT SMITH, AR 72913-3528
(479) 274-2000
(479) 274-2194

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
R-4520
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
110070328
RR MEDICARE
05
123894001
AR
Enumeration date
07/14/2006
Last updated
08/28/2015
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