Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN0400X | Neurology | 16296 | AR |
NPI | 1881367803 |
---|---|
Provider Name | Dr. Samuel D Cates |
First Address | Fayetteville, AR 72703-4427 |
Second Address | Fayetteville, AR 72703-4427 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/07/2021 |
Last Update Date | 27/07/2021 |