Individual
ROGER NEAL BISE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2713 S 74TH ST, SUITE 302, FORT SMITH, AR 72903-5170
(479) 478-8555
Mailing address
2713 S 74TH ST, SUITE 302, FORT SMITH, AR 72903-5170
(479) 478-8555
Taxonomy
Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
N-8072
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
148093002
—
AR
01
—
17633000000
QUALCHOICE
AR
01
—
P00702260
RAILROAD MEDICARE
—
Enumeration date
04/25/2006
Last updated
11/05/2009
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