Individual
DR. STEPHEN C. LATTANZI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
628 HOSPITAL DR, GROUND FLOOR, SUITE A, MOUNTAIN HOME, AR 72653-2953
(870) 425-4402
(860) 437-2236
Mailing address
PO BOX 2038, MOUNTAIN HOME, AR 72654-2038
(870) 424-7070
(870) 424-6616
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
035831
CT
207RH0003X
Hematology & Oncology Physician
035831
CT
207RH0003X
Hematology & Oncology Physician
Primary
E-9749
AR
207RX0202X
Medical Oncology Physician
035831
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001358317
—
CT
Enumeration date
07/07/2005
Last updated
12/15/2016
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