Individual
GARY P ANZALONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
208 THOMPSON AVE, EL DORADO, AR 71730-5756
(870) 862-1351
(870) 862-2815
Mailing address
208 THOMPSON AVE, EL DORADO, AR 71730-5756
(870) 862-1351
(870) 862-2815
Taxonomy
Speciality
Code
Description
License number
State
207ZC0500X
Cytopathology Physician
R-4500
AR
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
R-4500
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
123460001
—
AR
01
—
5J135
MEDICARE LEGACY NUMBER
AR
Enumeration date
05/11/2006
Last updated
06/12/2008
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