Fonticiella, Adalberto R

Fonticiella, Adalberto R is an sole proprietor health care provider with primary practice located at 1000 West Kingshighway Suite 12, Paragould AR 72450-8894. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Surgery, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Internal Medicine is his primary health care specialty. Fonticiella, Adalberto R can be contacted via phone (870) 236-6930.

Contact Information

Primary practice address
1000 West Kingshighway Suite 12 Paragould AR 72450-8894
Phone: (870) 236-6930
Fax: (870) 239-8065
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X C-6766 Arkansas
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X C-6766 Arkansas

Profile Details

NPI number 1922088269
LBN Legal business name Fonticiella, Adalberto R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 20th, 2006
Last updated Mar 20th, 2020 - about 5 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 1922088269 NPPES
Arkansas MEDICAID 157456002

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