Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | N8079 | AR |
N | 207YP0228X | Pediatric Otolaryngology | N8079 | AR |
N | 207YS0123X | Facial Plastic Surgeon | N8079 | AR |
N | 207YX0007X | Plastic Surgeon (Head & Neck) | N8079 | AR |
N | 207YX0905X | Otolaryngology/Facial Plastic Surgery | N8079 | AR |
NPI | 1629077896 |
---|---|
Provider Name | Dr. Paul Neis |
First Address | Mountain Home, AR 72653-2941 |
Second Address | Mountain Home, AR 72653-2941 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/07/2005 |
Last Update Date | 28/09/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
118929001 | (05) | AR |
15237000000 | QUALCOICE (01) | |
3252424-001 | CIGNA (01) | |
4190 | COX HEALTH PLANS (01) | |
4347202 | AETNA (01) | |
54488 | BLUE CROSS BLUE SHIELD (01) | AR |
B69421 | (02) | AR |