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Individual

DANA P RABIDEAU

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1500 DODSON AVE, STE 280, FORT SMITH, AR 72901-5182
(479) 709-7480
(479) 709-7479
Mailing address
PO BOX 402319, ATLANTA, GA 30384-2319
(479) 709-7399
(479) 709-7053

Taxonomy

Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
15018
OK
207RN0300X
Nephrology Physician
Primary
N6097
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100221460A
OK
05
105851001
AR
Enumeration date
10/06/2005
Last updated
08/23/2010
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