Pruiksma, Richard T
Pruiksma, Richard T is an individual health care provider with primary practice located at 500 S Mount Olive St Suite 200, Siloam Springs AR 72761-3602. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Pruiksma, Richard T can be contacted via phone (479) 524-9550.Contact Information
Primary practice address
500 S Mount Olive St Suite 200
Siloam Springs AR 72761-3602
Phone: (479) 524-9550
Fax: (479) 524-9552
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 20107 | Oklahoma |
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 04-28209 | Kansas |
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | E-0221 | Arkansas |
Profile Details
| NPI number | 1053357491 |
|---|---|
| LBN Legal business name | Pruiksma, Richard T |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 22nd, 2006 |
| Last updated | Jul 14th, 2014 - about 11 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1053357491 | NPPES |
| Arkansas | Other | 351793 | MEDICARE ID |
| Arkansas | Other | E-0221 | MEDICARE ID |
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