Individual
DIVINE RIBAKARE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
1500 DODSON AVE STE 280, FORT SMITH, AR 72901-5182
(479) 709-7480
(479) 709-7479
Mailing address
11001 EXECUTIVE CENTER DR STE 200, LITTLE ROCK, AR 72211-4393
(501) 812-7215
(501) 812-7207
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
34-011938
OH
207RN0300X
Nephrology Physician
DO185961
OR
207RN0300X
Nephrology Physician
Primary
E-12366
AR
Other
Enumeration date
03/20/2013
Last updated
06/15/2023
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