Phetsamone Peter Xaysanasy D.P.M.

NPI 1063456184 - Podiatrist - 213E00000X

NPI Details
NPI 1063456184
Gender Male
Enumeration Date 06/16/2006
Last Updated 01/03/2011
Entity Type Individual
Active Over 10 years ago
Practice Location
125 W SUNBRIDGE DR
SUITE 1
FAYETTEVILLE AR, 72703-1899, US
Phone (479) 251-9200
Fax
Business Location
125 W SUNBRIDGE DR
SUITE 1
FAYETTEVILLE AR, 72703-1899, US
Phone (479) 251-9200
Fax
Toxanomy
Taxonomy Code 213E00000X
License State Arkansas
License Number 193
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According to our database, Dr. Phetsamone Peter Xaysanasy D.P.M. NPI is 1063456184, taxonomy code is 213E00000X and license number is 193, license state is located at Arkansas. Phetsamone Peter Xaysanasy D.P.M. physically located at 125 W Sunbridge Dr, Fayetteville AR, 72703-1899. NPI Number Phetsamone Peter Xaysanasy D.P.M. has the Individual type.

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1063456184 NPI number is provided on an as is basis without warranty of any kind. 1063456184 is maintained by the National Plan & Provider Enumeration System. The contents of Phetsamone Peter Xaysanasy D.P.M. are for informational purposes only.