Organization Name: | ANES W. ABRAHAM M.D. P.A. |
NPI Number: | 1053490144 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | ANES WILEY ABRAHAM (PRESIDENT) |
Mailing Address: | 1521 N 10th St Suite H Blytheville |
State: | AR US |
Postal Code: | 723151405 |
Phone Number: | 8707631700 |
Fax Number: | 8707632903 |
NPI Enumeration Date: | 11/02/2006 |
NPI Last Update Date: | 07/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | R3291 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AR |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |