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Individual

MR. EDWARD DAVID AVANTS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHARMD

Contact information

Practice address
350 HIGHWAY 62 E, MOUNTAIN HOME, AR 72653-3629
(870) 424-3814
Mailing address
245 WAYNE DR, LAKEVIEW, AR 72642-7117
(870) 431-8187

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PD09103
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
PD09103
LOUISIANA 15540
AR
Enumeration date
09/30/2011
Last updated
09/30/2011
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