Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207SG0201X | Clinical Genetics (M.D.) | E-5996 | AR |
N | 208000000X | Pediatrician | 15033 | OK |
N | 2080P0205X | Pediatric Endocrinologist | 15033 | OK |
N | 2080P0205X | Pediatric Endocrinologist | E-5996 | AR |
NPI | 1457320913 |
---|---|
Provider Name | Adolfo D. Garnica |
First Address | Little Rock, AR 72202-3500 |
Second Address | Little Rock, AR 72202-3500 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/03/2006 |
Last Update Date | 16/06/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100217510C | (05) | OK |
D34677 | (02) | OK |