Individual
DR. ANTON CYRIL PETRASH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1100 N COLLEGE AVE, 116A/MHC, FAYETTEVILLE, AR 72703
(479) 444-5038
(479) 444-5039
Mailing address
3841 BRICKWAY BLVD, SANTA ROSA, CA 95403-8226
(707) 569-2367
(707) 569-2444
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
C156947
CA
2084P0800X
Psychiatry Physician
Primary
E0036
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
125759001
—
AR
01
—
5J418
BCBS PROV #
AR
Enumeration date
07/08/2006
Last updated
07/31/2018
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