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Individual

PATRIC ANDERSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
7301 ROGERS AVE, FORT SMITH, AR 72903-4100
(479) 314-6000
Mailing address
6830 PEACH DR, ALMA, AR 72921-7595
(479) 632-6326
(479) 632-5122

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
E-2148
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100142410B
OK
05
137508001
AR
Enumeration date
06/05/2006
Last updated
12/30/2008
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