Individual
DR. SUSAN L RABEN-TAYLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
525 N GARLAND AVE, FAYETTEVILLE, AR 72701-3110
(479) 582-1755
Mailing address
525 N GARLAND AVE, FAYETTEVILLE, AR 72701-3110
(870) 424-5079
(870) 424-8455
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
N-7882
AR
207QS0010X
Sports Medicine (Family Medicine) Physician
N-7882
AR
208VP0000X
Pain Medicine Physician
N-7882
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12990
QUALCHOICE INSURANCE ID#
AR
Enumeration date
07/03/2006
Last updated
03/20/2019
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