Individual
DAVID JACOB ROARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
104 W LINE AVE, RUSTON, LA 71270-5044
(318) 255-7363
(318) 255-7365
Mailing address
2135 N WEST AVE, EL DORADO, AR 71730-3351
(870) 862-5458
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
023778
LA
183500000X
Pharmacist
PN06516
AR
Other
Enumeration date
08/14/2020
Last updated
03/16/2021
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