Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | N7410 | AR |
N | 208100000X | Physical Medicine & Rehabilitation Doctor | N-7410 | AR |
Y | 2081P2900X | Pain Medicine | N-7410 | AR |
N | 208D00000X | General Practice Physician | N-7410 | AR |
NPI | 1326049255 |
---|---|
Provider Name | William S Piechal |
First Address | Fayetteville, AR 72703-4388 |
Second Address | Fayetteville, AR 72703 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/08/2005 |
Last Update Date | 14/01/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
114115003 | (05) | AR |
500767900 | (02) | AR |
D16967 | (02) | AR |