Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | E0020 | AR |
NPI | 1003850579 |
---|---|
Provider Name | Dr. John Frank Cuchia |
First Address | Fayetteville, AR 72703-1944 |
Second Address | Fayetteville, AR 72703-1944 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/06/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B22065 | (02) | AR |