Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN0400X | Neurology | 1341 | AR |
NPI | 1487711255 |
---|---|
Provider Name | Dr. Sarah J Loomis |
First Address | Hot Springs, AR 71913-4406 |
Second Address | Hot Springs, AR 71913-4406 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/01/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
59873 | BLUE CROSS BLUE SHIELD (01) | AR |