Individual
PIERRETTE LARISSE LAURE TANTCHOU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
813 FOUNDERS PARK DR E STE 101, SPRINGDALE, AR 72762-6321
(479) 463-2333
(479) 463-2357
Mailing address
2108 E CINNAMON WAY, FAYETTEVILLE, AR 72703-4536
(856) 283-5489
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
E-8326
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
202222001
—
AR
Enumeration date
06/27/2011
Last updated
06/27/2014
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