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Individual

DR. SARIKUN TJANDRA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
7001 ROGERS AVE STE 200, FORT SMITH, AR 72903-4022
(479) 314-4600
(479) 314-3630
Mailing address
7001 ROGERS AVE STE 200, FORT SMITH, AR 72903-4022
(479) 314-4600
(479) 314-3630

Taxonomy

Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
E-3340
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100224840A
OK
05
146689001
AR
Enumeration date
08/05/2006
Last updated
07/09/2012
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