Fontanilla, Jose Albert Ang

Fontanilla, Jose Albert Ang is an individual health care provider with primary practice located at 4077 Elm Springs Rd Ste 105 , Springdale AR 72762-3703. He recently has only one registered license in Allopathic & Osteopathic Physicians / Geriatric Medicine, which is considered as his primary health care specialty. Fontanilla, Jose Albert Ang can be contacted via phone (479) 927-2100.

Contact Information

Primary practice address
4077 Elm Springs Rd Ste 105 Springdale AR 72762-3703
Phone: (479) 927-2100
Fax: (479) 927-2211
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Geriatric Medicine 207RG0300X E3107 Arkansas

Profile Details

NPI number 1497712640
LBN Legal business name Fontanilla, Jose Albert Ang
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 28th, 2006
Last updated Sep 9th, 2020 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1497712640 NPPES
Arkansas MEDICAID 146213001

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