Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2086S0120X | Pediatric Surgery | 2000150873 | MO |
Y | 2086S0120X | Pediatric Surgery | E3246 | AR |
NPI | 1114931029 |
---|---|
Provider Name | Dr. Guy Raoul Rosenschein |
First Address | Springdale, AR 72766-6220 |
Second Address | Springdale, AR 72762-0876 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/07/2006 |
Last Update Date | 03/12/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100224750A | (05) | OK |
140114001 | (05) | AR |
18920000000 | QUALCHOICE (01) | AR |
200387580B | (05) | KS |
204878001 | (05) | MO |
2718271 | CIGNA (01) | AR |
45052125072764A003 | CHAMPUS/TRICARE (01) | AR |
515046 | HEALTHLINK (01) | AR |
5L780 | BLUE CROSS/BLUE SHIELD (01) | AR |
G72265 | (02) | AR |