Organization
CAESAR S. DIVINO D.P.M. PA
Active
Other names
Cabot Foot Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MR. HECTOR SOLOMON DIVINO (OFFICE MANAGER)
(501) 941-3797
Entity
Organization
Contact information
Practice address
3065 HIGHWAY 367 S, SUITE 11, CABOT, AR 72023-8660
(501) 941-3797
(501) 941-7760
Mailing address
3065 HIGHWAY 367 S, SUITE 11, CABOT, AR 72023-8660
(501) 941-3797
(501) 941-7760
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
164
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
145589748
—
AR
Enumeration date
05/24/2011
Last updated
05/24/2011
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