Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0201X | Internist - Allergy & Immunology | C7148 | AR |
NPI | 1518959691 |
---|---|
Provider Name | Dr. Karl Vance Sitz |
First Address | Little Rock, AR 72205-4565 |
Second Address | Little Rock, AR 72205-4565 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/08/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G27799 | (02) | AR |